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Increased serum concentration of carbohydrate-deficient transferrin in patients with combined pancreas and kidney transplantation

¹ Abteilung Klinische Chemie und Zentrallaboratorium, Baldingerstr.;
² Medizinisches Zentrum für Nervenheilkunde, Funktionsbereich Neurochemie, Rudolf-Bultmannstr. 8;
³ Abteilung Nephrologie, Baldingerstr., Philipps-Universität Marburg, D-35033 Marburg, Germany.
^a address for correspondence: bioscientia, Institut für Laboruntersuchungen Ingelheim GmbH, Hamburger Str. 1, D-55218 Ingelheim, Germany. Fax 49-6132-781-214; e-mail bioscientia{at}t-online.de

Serum concentration of carbohydrate-deficient transferrin (cCDT) is used for laboratory diagnosis and follow-up of chronic alcohol abuse. In analyzing by CDTect-RIA (Pharmacia) sera from outpatients with combined pancreas and kidney transplantation and no excessive alcohol consumption, we found above-normal values for cCDT and CDT/transferrin ratios (CDT/Tf) in more than half of the samples. Isoelectric focusing of these samples showed distinct bands of carbohydrate-deficient isotransferrins, supporting the abnormal findings from the CDTect assay. In contrast, diabetics and outpatients who had received only kidney transplants showed normal values for cCDT, CDT/Tf, and isotransferrin patterns. Increased serum Tf, sialidase-producing microorganisms, and immunosuppressive medication were eliminated as causes of these abnormal cCDT and CDT/Tf results. Successful pancreas transplantation leads to hyperinsulinemia and normoglycemia, in contrast to hypoinsulinemia and hyperglycemia in the patients who receive kidney transplants alone. These factors may have pathogenic importance for CDT increase, yielding results falsely interpreted as positive with respect to alcohol abuse in patients with combined pancreas and kidney transplantation.

Key Words: indexing terms: alcoholism • isoelectric focusing • isotransferrins • sialic acid-deficient transferrins

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