Fourteen combined cadaveric renal and segmental pancreatic transplantations with both of the organs provided by the same donor were performed, and exocrine diversion was to the recipient's bowel. Nine of the grafts have failed because of technical surgical complications, and 2 grafts failed because of rejection. Three patients are carrying well-functioning grafts 6, 19, and 24 months, respectively, after transplantation. Ten of the kidneys are functioning; thus, the use of combined transplantation has not jeopardized the results of renal grafting. Patients who had functioning pancreatic grafts had normal or near-normal fasting blood glucose levels; studies of intravenous glucose tolerance test revealed k-values around or just over 1.0 and glycosylated hemoglobin levels were normal. When azathioprine was replaced with cyclosporine, 4 of 6 patients showed a significant decline in k-value. This deterioration in blood glucose control was reversible by dosage adjustment.
Five patients with chronic continuous Crohn's colitis were treated with peroral Cyclosporin A (CyA) for 3 months in an open, uncontrolled pilot trial. The CyA dose was 10 mg kg-1 d-1 the first month of study, and thereafter 5 mg kg-1 d-1. Three of the patients initially showed some response to the treatment with decreases in the Crohn's disease activity index, but subsequently deteriorated. In one patient the condition was unchanged and another clearly worsened. Increases in serum creatinine levels were noted in three patients, and all of these also had decreased 51Cr-EDTA clearance indicating impaired renal function. Hypertrichosis and hyperaesthesia were also noted as side-effects. This study does not support the use of CyA in the short-term treatment of Crohn's disease in the colon.
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