Autoimmunity in Autologous Islet Transplantation

Area of Science:

• Endocrinology
• Immunology
• Gastroenterology

Background:

• Total pancreatectomy (TP) is a treatment for chronic pancreatitis (CP).
• Autologous islet transplantation (AIT) after TP aims to prevent surgical diabetes.
• Autoimmunity is not typically considered a risk for graft failure in TP + AIT patients.

Purpose of the Study:

• To report cases of new-onset beta-cell autoimmunity after TP and AIT.
• To investigate potential autoimmune islet graft failure in this patient population.

Main Methods:

• Case report of two patients undergoing TP and AIT.
• Monitoring for glycemic control and autoimmune markers (glutamic acid decarboxylase antibodies).

Main Results:

• Both patients developed de novo glutamic acid decarboxylase antibody positivity.
• Both patients experienced rapid deterioration of glycemic control, requiring insulin.
• This suggests a new-onset autoimmune phenomenon affecting the islet graft.

Conclusions:

• Beta-cell autoimmunity should be considered in TP and AIT patients with unexpected glycemic control decline.
• Autoimmune islet graft failure may be underreported in this population.
• Further investigation into autoimmune risks post-TP + AIT is warranted.