Metabolic and immunological features of the failing islet-transplanted patient.

Abstract

This retrospective study was designed to identify metabolic and immune predictors of early islet allograft failure. We measured several metabolic and immunological markers at the time of pretransplant and several time points posttransplantation in 17 patients with long-term functioning graft (long fx) and 20 patients with short-term functioning graft (short fx). The short fx group showed higher insulin resistance, altered proinsulin processing, lower soluble interleukin-2 receptor (sIL-2r) (marker of T-cell activation), and higher soluble FasL (marker of apoptosis) during the entire follow-up, particularly at time of failure. Patients who experienced an early failure of islet allograft showed specific metabolic and immunological signs long before islet failure.