Use of tacrolimus and mycophenolate mofetil as induction and maintenance in simultaneous pancreas-kidney transplantation

G. Ciancio, A. Lo Monte, G. Buscemi, J. Miller, G. W. Burke

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Clinical trials using quadruple immunosuppression that include the combination of tacrolimus and mycophenolate mofetil have been shown to reduce the incidence of acute rejection episodes in simultaneous pancreas-kidney (SPK) transplantation. In an attempt to obtain a low rejection rate without antibody induction therapy, we undertook a prospective study of combined tacrolimus and mycophenolate mofetil and steroids as primary immunosuppression for SPK transplantation. In this study, we analyzed 17 patients who received low-dose intravenous tacrolimus as induction therapy. This was combined with oral tacrolimus, mycophenolate mofetil, and steroids as the primary immunosuppression regimen. There was a significant reduction of empirically and biopsy-proven rejection with an incidence of 23% (4 patients). Leukopenia, gastroparesis, and gastrointestinal side-effects were the cause of discontinuation of mycophenolate mofetil, or low tacrolimus trough level in those patients who developed rejection. All rejection episodes were easy to treat, and none of them required antibody therapy. The combination of tacrolimus with mycophenolate mofetil without antibody induction therapy is effective in preventing early acute rejection. This combination is safe and effective as an alternative immunosuppressive regimen after SPK transplantation.

Original languageEnglish (US)
Pages (from-to)S191-S194
JournalTransplant International
Volume13
Issue numberSUPPL. 1
StatePublished - Dec 1 2000

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Keywords

  • Acute rejection
  • Induction therapy
  • Mycophenolate mofetil
  • Simultaneous pancreas-kidney transplantation
  • Tacrolimus

ASJC Scopus subject areas

  • Transplantation

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