Pancreas-specific protein (PASP), serum amyloid A (SAA), and neopterin (NEOP) in the diagnosis of rejection after simultaneous pancreas and kidney transplantation |
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| Authors: | T F Müller F Trösch H Ebel R W G Grüssner H Feiber B Göke B Greger H Lange |
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| Institution: | (1) Department of Nephrology, Center of Internal Medicine, Philipps-University of Marburg, Baldingerstrasse 1, D-35 033 Marburg, Germany, Fax: + 49 6421 21763, DE;(2) Department of Surgery, Philipps-University of Marburg, Baldingerstrasse 1, D-35 033 Marburg, Germany, DE;(3) Department of Urology, Philipps-University of Marburg, Baldingerstrasse 1, D-35 033 Marburg, Germany, DE;(4) Department of Gastroenterology, Philipps-University of Marburg, Baldingerstrasse 1, D-35 033 Marburg, Germany, DE |
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| 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.
Received: 23 July 1996 Received after revision: 31 December 1996 Accepted: 3 January 1997 |
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| Keywords: | Pancreas-specific protein pancreas transplantation Neopterin pancreas transplantation Serum amyloid A pancreas transplantation Pancreas transplantation rejection parameters Rejection pancreas transplantation |
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