118-OR: HLA Matching and Clinical Outcomes in Islet Transplantation

Abstract

Islet cell transplantation (ITx) is a treatment option for selected patients with type 1 diabetes mellitus (T1D) affected by severe hypoglycemia. In whole organ transplantation, HLA mismatching has been shown to negatively impact transplant outcomes. However, this has not been studied in ITx and currently, HLA matching is not a criteria for donor selection. The aim of this study was to determine whether HLA matching has an impact on islet allograft survival. We evaluated 50 ITx recipients at the Diabetes Research Institute, University of Miami, who have been followed from 2000 to 2019. Out of the 50 subjects, 7 underwent islet after kidney transplantation and 43 islet transplantation alone. Subjects received an average of 2 islet infusions from 1 to 5 donors. We evaluated whether the number of HLA-A, -B, and -DR matches were associated with Graft Dysfunction and Graft Failure events using Kaplan-Meier Analysis, including log-rank and Wilcoxon tests statistics. Analyses did not show a significant association between HLA matching and allograft survival (p>0.05). Nevertheless, 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. HLA mismatching did not affect ITx outcomes in our study cohort. Further studies are necessary to determine if HLA matching plays a significant role in ITx graft survival. Disclosure V. Fuenmayor: None. C. Chavez: None. D. Baidal: None. A.M. Alvarez: None. N. Padilla: None. C. Ricordi: None. R. Alejandro: None. Funding Diabetes Research Institute Foundation; The Leona M. and Harry B. Helmsley Charitable Trust; University of Miami Clinical and Translational Science Institute