Table 2.
Influence of immune parameters on outcome in 31 islet transplant recipients.
| End-point |
Insulin independence |
C-peptide production (AUC) over 26 weeks (weeks × ng/ml) |
|||
|---|---|---|---|---|---|
| Variable | (n) | N (%) | P* | Median (range) | P** |
| Immunosuppressive protocol | TAC–MMF (21) | 13 (62%) | 0·04 | 40·43 (3·56–68·63) | 0·01 |
| TAC–SIR (5) | 3 (60%) | 33·46 (5·12–51·97) | |||
| SIR (5) | 0 (0%) | 8·77 (2·99–20·91) | |||
| All injections ≥ 2·0 × 106β cells/kg | No (10) | 2 (20%) | 0·02 | 40·43 (3·30–68·63) | 0·007 |
| Yes (21) | 14 (67%) | 15·22 (2·99–40·78) | |||
| Pretransplant cellular autoreactivity | No reactivity (11) | 9 (82%) | 0·004 | 51·97 (2·99–68·63) | 0·01 |
| IA-2 or GAD (6) | 4 (67%) | 31·18 (14·59–40·78) | |||
| IA-2 and GAD (6) | 0 (0%) | 12·39 (3·56–42·79) | |||
| Post-transplant cellular autoreactivity | No reactivity (9) | 5 (56%) | 0·15 | 35·45 (22·81–65·85) | 0·62 |
| IA-2 or GAD (12) | 5 (42%) | 33·83 (3·30–68·63) | |||
| IA-2 and GAD (6) | 2 (33%) | 26·33 (2·99–51·97) | |||
| Overall post-transplant cellular alloreactivity (CTLp) | Low (17) | 10 (65%) | 0·46 | 31·75 (3·56–64·19) | 0·74 |
| High (13) | 5 (38%) | 33·83 (2·99–68·63) | |||
| % donors with high CTLp frequency | (30) | 15 (50%) | 0·03** | 33·46 (2·99–68·63) | 0·53*** |
*
P-values calculated by χ2 test or Fisher's exact test;
**
calculated by Mann–Whitney U- or Kruskal–Wallis test;
***
P-value calculated by Spearman's correlation, r = −0·12. Autoreactivity data were unavailable for eight patients, alloreactivity data for one patient. AUC, area under the curve; CTLp, cytotoxic T lymphocyte precursor assay; GAD, glutamic acid decarboxylase; IA-2, islet antigen-2; MMF, mycophenolate mofetil; SIR, sirolimus; TAC, tacrolimus.