Resolution of neurotoxicity and β-cell toxicity in an islet transplant recipient following substitution of tacrolimus with MMF

Tatiana Froud, David A. Baidal, Gaston Ponte, Jacqueline V. Ferreira, Camille Ricordi, Rodolfo Alejandro

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Calcineurin inhibitors such as tacrolimus have well-recognized efficacy in organ transplantation but side effects of nephrotoxicity, neurotoxicity, and β-cell toxicity that can be particularly detrimental in islet transplantation. Neuro- and nephrotoxicity have been demonstrated in multiple islet transplant recipients despite the relatively low serum maintenance levels typically used (3-5 ng/ml). We describe a single patient in whom symptoms and signs of neurotoxicity necessitated substitution of tacrolimus with mycophenolate mofetil (MMF), which resulted in complete symptom resolution over the subsequent 9 months. Concomitantly noted were an almost immediate improvement in glycemic control and an improved response to stimulation testing, suggesting remission of tacrolimus-induced β-cell toxicity and insulin resistance. At 18 months post-"switch," 30 months posttransplant, the patient remains insulin independent with good glycemic control. The goal to remove calcineurin inhibitors from regimens of islet transplantation is a worthy one.

Original languageEnglish (US)
Pages (from-to)613-620
Number of pages8
JournalCell Transplantation
Volume15
Issue number7
DOIs
StatePublished - Dec 18 2006

Keywords

  • β-cell toxicity
  • Function
  • Islet
  • Neurotoxicity
  • Tacrolimus
  • Transplantation

ASJC Scopus subject areas

  • Cell Biology
  • Transplantation

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