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

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

Research output: Contribution to journalArticle

27 Citations (Scopus)

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

Fingerprint

Mycophenolic Acid
Transplants
Insulin
Tacrolimus
Toxicity
Islets of Langerhans Transplantation
Substitution reactions
Transplantation (surgical)
Switches
Organ Transplantation
Signs and Symptoms
Insulin Resistance
Testing
Maintenance
Serum
Transplant Recipients
Calcineurin Inhibitors

Keywords

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

ASJC Scopus subject areas

  • Cell Biology
  • Transplantation

Cite this

Resolution of neurotoxicity and β-cell toxicity in an islet transplant recipient following substitution of tacrolimus with MMF. / Froud, Tatiana; Baidal, David; Ponte, Gaston; Ferreira, Jacqueline V.; Ricordi, Camillo; Alejandro, Rodolfo.

In: Cell Transplantation, Vol. 15, No. 7, 18.12.2006, p. 613-620.

Research output: Contribution to journalArticle

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