Islet transplantation (ITx) has demonstrated efficacy in improving glycemic control and abolishing severe hypoglycemia in patients affected with type 1 diabetes (T1D). Several factors account for graft loss and recurrence of autoimmunity has been suggested as a contributor to graft failure but remains controversial. We hypothesized that ITx recipients of HLA DR4+ donors could be at increased risk for recurrence of autoimmunity, as DR4+ is a well-known risk factor for T1D.

We evaluated 50 ITx recipients transplanted at the Diabetes Research Institute, University of Miami, who have been followed from 2000 to 2019. Out of the 50 subjects, 7 received islet after kidney transplantation and 43 islet transplantation alone. Subjects received an average of 2 islet infusions from 1 to 5 donors. The data was analyzed using Kaplan-Meier Survival Curves, along with log-rank and Wilcoxon tests statistics.

No significant association was found between Donor DR4+ and islet transplant outcomes (>0.05). However, our study is limited by the small sample size, use of multiple donors as well as differences in immunosuppression regimens and use of GLP-1 analogs and DPP-4 inhibitors which may have affected outcomes.

Our data suggests that donor DR4+ is not associated with transplantation outcomes in our study cohort. Further studies are required to validate these findings.


C. Chavez: None. V. Fuenmayor: None. D. Baidal: None. A.M. Alvarez: None. N. Padilla: None. C. Ricordi: None. R. Alejandro: None.


Diabetes Research Institute Foundation; State of Florida; JDRF; The Leona M. and Harry B. Helmsley Charitable Trust; University of Miami Clinical and Translational Science Institute

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