INCREASED SERUM CONCENTRATION OF CARBOHYDRATE-DEFICIENT TRANSFERRIN IN PATIENTS WITH COMBINED PANCREAS AND KIDNEY-TRANSPLANTATION

Serum concentration of carbohydrate-deficient transferrin (cCDT) is us ed for laboratory diagnosis and follow-up of chronic alcohol abuse. In analyzing by CDTect-RIA (Pharmacia) sera from outpatients with combin ed pancreas and kidney transplantation and no excessive alcohol consum ption, we found above-normal values for cCDT and CDT/transferrin ratio s (CDT/Tf) in more than half of the samples. Isoelectric focusing of t hese samples showed distinct bands of carbohydrate-deficient isotransf errins, supporting the abnormal findings from the CDTect assay. In con trast, diabetics and outpatients who had received only kidney transpla nts showed normal values for cCDT, CDT/Tf, and isotransferrin patterns . Increased serum Tf, sialidase-producing microorganisms, and immunosu ppressive medication were eliminated as causes of these abnormal cCDT and CDT/Tf results. Successful pancreas transplantation leads to hyper insulinemia and normoglycemia, in contrast to hypoinsulinemia and hype rglycemia in the patients who receive kidney transplants alone. These factors may have pathogenic importance for CDT increase, yielding resu lts falsely interpreted as positive with respect to alcohol abuse in p atients with combined pancreas and kidney transplantation.