Specific humoral rejection of a pancreas allograft in a recipient of pancreas after kidney transplantation.

A 46 year-old male patient who had received a pancreas transplant,subsequent to a kidney transplant (PAK) for diabetes nephropathy,was admitted to our transplant unit for an acute hyperglycaemiaassociated with a mild increase of creatinine. His type 1 diabetes was declared around his 5th birthday andwas complicated by a proliferative retinopathy, nephropathy,arteritis and ischaemic cardiomyopathy. After a 4-year period of haemodialysis, a renal transplantationwas performed in August 1996 from a deceased donor sharing onlyone human leukocyte antigen (HLA) DR Ag (Table 1). After a shortperiod of delayed graft function, renal function improved andstabilized at a creatinine level of around 140 µmol/l.Initial immunosuppression included induction treatment withanti-T lymphocyte globulins (Thymoglobulin, Genzyme, USA) anda maintenance regimen associating tacrolimus and