Pilot study of early corticosteroid elimination after pancreas transplantation

TitlePilot study of early corticosteroid elimination after pancreas transplantation
Publication TypeJournal Article
Year of Publication2005
AuthorsHanaway MJ, Roy-Chaudhury P, Buell JF, Thomas M, Munda R, Alloway RR, Ellison V, Rudich SM, Fisher L, Woodle ES
JournalTransplant Proc
Pagination1287 - 8
Date PublishedMar
Accession Number15848698
KeywordsAdrenal Cortex Hormones / *administration & dosage / adverse, Adult, Continental Population Groups, Diabetes Mellitus, Type 1 / *surgery, Diabetic Nephropathies / immunology / surgery, Drug Administration Schedule, effects / therapeutic use, Female, Graft Rejection / epidemiology, Humans, Immunosuppressive Agents / therapeutic use, Kidney Failure, Chronic / surgery, Kidney Transplantation / physiology, Male, Ohio, Pancreas Transplantation / immunology / *physiology, Pilot Projects

Early corticosteroid withdrawal has recently been shown to be possible in recipients of simultaneous pancreas kidney transplants; however, its feasibility in solitary pancreas recipients has not been documented. In the present study, we provide evidence that early withdrawal can be achieved in pancreas as well as pancreas-kidney recipients. METHODS: Twenty type I diabetics underwent 13 pancreas-kidney transplants and 7 pancreas-only transplants with early withdrawal (methylprednisone 6-day taper). Additional immunosuppression consisted of tacrolimus, mycophenolate mofetil, and thymoglobulin induction (five doses). RESULTS: Transplants included 13 pancreas-kidney, 6 pancreas after kidney transplant, and 1 pancreas after islet transplant. Overall mean follow-up was 7.3 months. One episode of pancreas transplant rejection after pancreas-only transplant was detected on protocol biopsy without biochemical abnormalities. One renal allograft rejection occurred 65 days posttransplant in a pancreas-kidney recipient and was graded as a Banff IA rejection. A single pancreas graft loss occurred due to thrombosis 6 days after pancreas-kidney transplantation. CONCLUSIONS: These results indicate that relatively short thymoglobulin induction (five doses) with tacrolimus and mycophenolate mofetil can allow early withdrawal in both pancreas-kidney and pancreas-only transplant recipients.

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