RT info:eu-repo/semantics/article T1 Beta cell death by cell-free DNA and outcome after clinical islet transplantation A1 Gala Lopez, Boris L. A1 Neiman, Daniel A1 Kin, Tatsuya A1 O’Gorman, Doug A1 Pepper, Andrew R. A1 Malcolm, Andrew J. A1 Pianzin, Sheina A1 Senior, Peter A. A1 Campbell, Patricia A1 Glaser, Benjamin A1 Dor, Yuval A1 Shemer, Ruth A1 Shapiro, A.M. James AB Background: Optimizing engraftment and early survival after clinical islet transplantation is critical to long-term function, but there are no reliable, quantifiable measures to assess beta cell death. Circulating cell free DNA (cfDNA) derived from beta cells has been identified as a novel biomarker to detect cell loss, and was recently validated in new-onset type 1 diabetes and in islet transplant patients. Methods: Herein we report beta cell cfDNA measurements after allotransplantation in 37 subjects and the correlation with clinical outcomes. Results: A distinctive peak of cfDNA was observed 1hr after transplantation in 31/37 (83.8%) of subjects. The presence and magnitude of this signal did not correlate with transplant outcome. The 1hr signal represents dead beta cells carried over into the recipient after islet isolation and culture, combined with acute cell death post infusion. Beta cell cfDNA was also detected 24hrs post-transplant (8/37 subjects, 21.6%). This signal was associated with higher 1-month insulin requirements (p=0.04), lower 1-month stimulated C-peptide levels (p=0.01) and overall worse 3-month engraftment, by insulin independence (ROC:AUC=0.70, p=0.03) and Beta 2 score (ROC:AUC=0.77, p=0.006). Conclusions: cfDNA-based estimation of beta cell death 24hrs after islet allotransplantation correlates with clinical outcome and could predict early engraftment. PB Wolters Kluger SN 0041-1337 YR 2018 FD 2018 LK http://uvadoc.uva.es/handle/10324/36577 UL http://uvadoc.uva.es/handle/10324/36577 LA spa NO Transplantation, June 2018, 102. 978-985 DS UVaDOC RD 26-dic-2024