Pancreas-specific protein (PASP), serum amyloid A (SAA), and neopterin (NEOP) in the diagnosis of rejection after simultaneous pancreas and kidney transplantation

T. F. Müller, F. Trösch, H. Ebel, R. W.G. Grüssner, H. Feiber, B. Göke, B. Greger, H. Lange

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

A reliable, noninvasive indicator of pancreatic allograft rejection is urgently needed. In this study, serum (S), plasma (P), and urine (U) levels of pancreas-specific protein (P-PASP, U-PASP), neopterin (S-NEOP, U-NEOP), amylase (U-AMYL), and amyloid A (SAA) were measured daily in ten type I diabetic patients following simultaneous pancreas and kidney transplantation (SPK). Rejection episodes occurred in three isolated pancreas, nine isolated kidney, and five simultaneous pancreas and kidney transplants. In the case of the eight pancreas rejections, SAA was the rejection marker with the highest diagnostic accuracy (94%). Using P-PASP and U-PASP, an accuracy of 81% and 79%, respectively, was achieved. During viral infections, U-NEOP levels increased to a maximum level of 1904 μmol/mol creatinine, whereas during bacterial infections, SAA levels increased to a maximum value of 43 mg/dl. SAA, measured for the first time in SPK, appears to be a valuable rejection parameter. In combination with U-NEOP and U-AMYL, a differential diagnosis between rejection, bacterial infection, and viral infection was possible. Neither U-PASP nor P-PASP monitoring led to a significant improvement in the results.

Original languageEnglish (US)
Pages (from-to)185-191
Number of pages7
JournalTransplant International
Volume10
Issue number3
DOIs
StatePublished - May 1997

Keywords

  • Neopterin, pancreas transplantation
  • Pancreas transplantation, rejection parameters
  • Pancreas-specific protein, pancreas transplantation
  • Rejection, pancreas transplantation
  • Serum amyloid A, pancreas transplantation

ASJC Scopus subject areas

  • Transplantation

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