Early markers of pancreas transplant rejection

To compare the predictive value of urinary amylase (UA), urinary insulin (UI), and urinary prostaglandin (PGE2), whole pancreas isografts or allografts from (ACI rat donors, RT1a) with bladder drainage of exocrine secretions were performed in Lewis rats (RT1(1)) with streptozotocin-induced diabetes. UA, UI, PGE2 and plasma glucose levels were measured daily. Euglycemia was restored on Postoperative Day 1 in all the recipients of isografts (N = 6) and was maintained for over a year. UI concentrations and PGE2 outputs were stable, with low levels ranging between 0.3 +/- 0.2 to 7 +/- 2 ng/ml and 56 +/- 15 to 164 +/- 48 ng/24 hr, respectively, while UA levels were significantly elevated compared to normal controls (> 1,000 U/ml vs 29 +/- 16 U/ml). In the allograft group (N = 12), rejection occurred on Days 7 through 9, with a mean graft survival time of 8.1 +/- 0.1 days. UA dropped from a post-transplant peak of 2,422 +/- 353 U/ml on Postoperative Day 4 to below 1,380 +/- 256 U/ml 3 days before rejection (Day -3). UI increased to 83 +/- 16 ng/ml (P < 0.05) on Day -6 and reached a post-transplant peak of 140 +/- 24 ng/ml on Day -5, while PGE2 output rose from a pretransplant level of 18 +/- 2 to 92 +/- 25 ng/24 hr on Postoperative Day 1, followed by a significant elevation on Day 4 (-4).(ABSTRACT TRUNCATED AT 250 WORDS)