In T1D recipients of SPK, despite immunosupression, recurrence of T1D has been demonstrated by onset of hyperglycemia in the setting of islet autoantibodies seroconversion, in addition to identification of circulating pathogenic autoreactive CD4 T-cells and histology proven insulitis and β-cell loss, in the absence of allo-rejection (12). The gene discussed is CD4; the disease is type 1 diabetes mellitus.