Outcomes of Pancreas Transplant Recipients with de novo Donor Specific Antibodies

Background Development of denovo donor-specific antibodies (dnDSA) has detrimental effects on graft survival in several types of solid organ transplants. But limited information exists about the effect of dnDSA on pancreas transplant graft survival. Methods We report our experience with pancreas recipients transplanted between 01/01/2005 and 08/31/2017. Results We identified 541 pancreas transplant recipients, of which 121 developed dnDSA and 420 did not. 32% developed dnDSA against HLA class I antigens, 56% developed against class II antigens and 12% developed against both. 52% of the patients in the dnDSA+ and 24% in the dnDSA- group underwent pancreas biopsy, mainly due to a rise in pancreatic enzymes. Rejection was found in 42% of the dnDSA+ group, and 20% of the dnDSA- group(p

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