The use of intravenous tacrolimus and mycophenolate mofetil as induction and maintenance immunosuppression in simultaneous pancreas-kidney recipients with previous transplants

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Clinical trials using quadruple immunosuppression that include the combination of tacrolimus (TAC) and mycophenolate mofetil (MMF) have been shown to reduce the incidence of acute rejection episodes in simultaneous pancreas-kidney (SPK) transplantation. In attempting to obtain a low rejection rate without antibody induction therapy, we proceeded with the combination of TAC intravenous (i.v.), MMF, and steroids as induction therapy and as primary immunosuppression for recipients with previous transplants. In this study, we analyzed 10 patients who received previous transplants, treated with low-dose TAC i.v. as induction therapy. Group A consisted of 6 patients with previous transplants that underwent SPK and group B consisted of four recipients with previous SPK that underwent cadaveric kidney transplants. For group A, the previous transplants were: living related kidney (LRK) followed by islet cell (IC) transplant (n = 2), LRK transplant (n = 1), cadaver kidney (CAD) and IC transplant (n = 1), SPK (n = 1), and three previous CAD kidney transplants (n = 1). In group A, all six kidneys were lost due to recurrent diabetic nephropathy, IC possibly to rejection, and the pancreas due to thrombosis. In group B with previous SPK transplants, three recipients lost their kidney to chronic rejection and one to long-term use of a nephrotoxic antibiotic. Currently, in all group A and B patients, the kidney and the pancreas are functioning, although 1 patients in group A developed type 2 diabetes (normal fasting C-peptide). Two patients in group A developed three rejection episodes that responded to steroid treatment. The results indicate the TAC i.v. in combination with oral TAC, MMF, and steroids offer effective induction therapy in patients with previous transplants.

Original languageEnglish
Pages (from-to)142-145
Number of pages4
JournalClinical Transplantation
Volume15
Issue number2
DOIs
StatePublished - Apr 2 2001

Fingerprint

Mycophenolic Acid
Tacrolimus
Immunosuppression
Pancreas
Maintenance
Transplants
Kidney
Islets of Langerhans
Steroids
Cadaver
Therapeutics
Pancreas Transplantation
C-Peptide
Diabetic Nephropathies
Kidney Transplantation
Type 2 Diabetes Mellitus

Keywords

  • Induction therapy
  • Mycophenolate mofetil
  • Previous transplants
  • Simultaneous pancreas-kidney transplants
  • Tacrolimus

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

@article{e6be582eefde4c43ad572ae0958cc957,
title = "The use of intravenous tacrolimus and mycophenolate mofetil as induction and maintenance immunosuppression in simultaneous pancreas-kidney recipients with previous transplants",
abstract = "Clinical trials using quadruple immunosuppression that include the combination of tacrolimus (TAC) and mycophenolate mofetil (MMF) have been shown to reduce the incidence of acute rejection episodes in simultaneous pancreas-kidney (SPK) transplantation. In attempting to obtain a low rejection rate without antibody induction therapy, we proceeded with the combination of TAC intravenous (i.v.), MMF, and steroids as induction therapy and as primary immunosuppression for recipients with previous transplants. In this study, we analyzed 10 patients who received previous transplants, treated with low-dose TAC i.v. as induction therapy. Group A consisted of 6 patients with previous transplants that underwent SPK and group B consisted of four recipients with previous SPK that underwent cadaveric kidney transplants. For group A, the previous transplants were: living related kidney (LRK) followed by islet cell (IC) transplant (n = 2), LRK transplant (n = 1), cadaver kidney (CAD) and IC transplant (n = 1), SPK (n = 1), and three previous CAD kidney transplants (n = 1). In group A, all six kidneys were lost due to recurrent diabetic nephropathy, IC possibly to rejection, and the pancreas due to thrombosis. In group B with previous SPK transplants, three recipients lost their kidney to chronic rejection and one to long-term use of a nephrotoxic antibiotic. Currently, in all group A and B patients, the kidney and the pancreas are functioning, although 1 patients in group A developed type 2 diabetes (normal fasting C-peptide). Two patients in group A developed three rejection episodes that responded to steroid treatment. The results indicate the TAC i.v. in combination with oral TAC, MMF, and steroids offer effective induction therapy in patients with previous transplants.",
keywords = "Induction therapy, Mycophenolate mofetil, Previous transplants, Simultaneous pancreas-kidney transplants, Tacrolimus",
author = "Gaetano Ciancio and Joshua Miller and Burke, {George W}",
year = "2001",
month = "4",
day = "2",
doi = "10.1034/j.1399-0012.2001.150211.x",
language = "English",
volume = "15",
pages = "142--145",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - The use of intravenous tacrolimus and mycophenolate mofetil as induction and maintenance immunosuppression in simultaneous pancreas-kidney recipients with previous transplants

AU - Ciancio, Gaetano

AU - Miller, Joshua

AU - Burke, George W

PY - 2001/4/2

Y1 - 2001/4/2

N2 - Clinical trials using quadruple immunosuppression that include the combination of tacrolimus (TAC) and mycophenolate mofetil (MMF) have been shown to reduce the incidence of acute rejection episodes in simultaneous pancreas-kidney (SPK) transplantation. In attempting to obtain a low rejection rate without antibody induction therapy, we proceeded with the combination of TAC intravenous (i.v.), MMF, and steroids as induction therapy and as primary immunosuppression for recipients with previous transplants. In this study, we analyzed 10 patients who received previous transplants, treated with low-dose TAC i.v. as induction therapy. Group A consisted of 6 patients with previous transplants that underwent SPK and group B consisted of four recipients with previous SPK that underwent cadaveric kidney transplants. For group A, the previous transplants were: living related kidney (LRK) followed by islet cell (IC) transplant (n = 2), LRK transplant (n = 1), cadaver kidney (CAD) and IC transplant (n = 1), SPK (n = 1), and three previous CAD kidney transplants (n = 1). In group A, all six kidneys were lost due to recurrent diabetic nephropathy, IC possibly to rejection, and the pancreas due to thrombosis. In group B with previous SPK transplants, three recipients lost their kidney to chronic rejection and one to long-term use of a nephrotoxic antibiotic. Currently, in all group A and B patients, the kidney and the pancreas are functioning, although 1 patients in group A developed type 2 diabetes (normal fasting C-peptide). Two patients in group A developed three rejection episodes that responded to steroid treatment. The results indicate the TAC i.v. in combination with oral TAC, MMF, and steroids offer effective induction therapy in patients with previous transplants.

AB - Clinical trials using quadruple immunosuppression that include the combination of tacrolimus (TAC) and mycophenolate mofetil (MMF) have been shown to reduce the incidence of acute rejection episodes in simultaneous pancreas-kidney (SPK) transplantation. In attempting to obtain a low rejection rate without antibody induction therapy, we proceeded with the combination of TAC intravenous (i.v.), MMF, and steroids as induction therapy and as primary immunosuppression for recipients with previous transplants. In this study, we analyzed 10 patients who received previous transplants, treated with low-dose TAC i.v. as induction therapy. Group A consisted of 6 patients with previous transplants that underwent SPK and group B consisted of four recipients with previous SPK that underwent cadaveric kidney transplants. For group A, the previous transplants were: living related kidney (LRK) followed by islet cell (IC) transplant (n = 2), LRK transplant (n = 1), cadaver kidney (CAD) and IC transplant (n = 1), SPK (n = 1), and three previous CAD kidney transplants (n = 1). In group A, all six kidneys were lost due to recurrent diabetic nephropathy, IC possibly to rejection, and the pancreas due to thrombosis. In group B with previous SPK transplants, three recipients lost their kidney to chronic rejection and one to long-term use of a nephrotoxic antibiotic. Currently, in all group A and B patients, the kidney and the pancreas are functioning, although 1 patients in group A developed type 2 diabetes (normal fasting C-peptide). Two patients in group A developed three rejection episodes that responded to steroid treatment. The results indicate the TAC i.v. in combination with oral TAC, MMF, and steroids offer effective induction therapy in patients with previous transplants.

KW - Induction therapy

KW - Mycophenolate mofetil

KW - Previous transplants

KW - Simultaneous pancreas-kidney transplants

KW - Tacrolimus

UR - http://www.scopus.com/inward/record.url?scp=0035098554&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035098554&partnerID=8YFLogxK

U2 - 10.1034/j.1399-0012.2001.150211.x

DO - 10.1034/j.1399-0012.2001.150211.x

M3 - Article

C2 - 11264642

AN - SCOPUS:0035098554

VL - 15

SP - 142

EP - 145

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 2

ER -