Long-Term Renal Transplant Function in Recipient of Simultaneous Kidney and Pancreas Transplant Maintained With Two Prednisone-Free Maintenance Immunosuppressive Combinations: Tacrolimus/Mycophenolate Mofetil Versus Tacrolimus/Sirolimus

Gallon, Lorenzo; Winoto, Johan; Chhabra, Darshika; Parker, Michele; Leventhal, Joseph R.; Kaufman, Dixon B.

doi:10.1097/01.tp.0000264189.58324.91

Cited by 43 publications

(24 citation statements)

References 19 publications

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“…Whether sirolimus-based immunosuppression affects outcome after SPK is unknown. Another research group recently showed [28] a trend towards increased prevalence of renal allograft loss in a tacrolimus/sirolimus-treated group. We found a statistically significant higher number of patients with pancreas-related complications in the group treated with the tacrolimus/sirolimus regimen.…”

Section: Discussionmentioning

confidence: 97%

Influence of donor- and recipient-specific factors on the postoperative course after combined pancreas–kidney transplantation

Fellmer

Pascher

Kahl

et al. 2009

Langenbecks Arch Surg

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Early postoperative complications after combined pancreas-kidney transplantation have a considerable effect on short- and long-term outcomes. Several statistically relevant factors related to pancreas- or surgery-associated complications could be identified. These data may help to improve early outcome after SPK by consideration of relevant risk factors when choosing an organ and a recipient for transplantation.

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Section: Discussionmentioning

confidence: 97%

Influence of donor- and recipient-specific factors on the postoperative course after combined pancreas–kidney transplantation

Fellmer

Pascher

Kahl

et al. 2009

Langenbecks Arch Surg

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“…RDP has been used with a number of different maintenance protocols (27)(28)(29)(30). A recent meta-analysis by Pascual et al (12) suggested that RDP with cyclosporine, but not tacrolimusbased protocols, was associated with increased AR rates, whereas RDP with tacrolimus, but not cyclosporine-based protocols, was associated with increased NODM.…”

Section: Discussionmentioning

confidence: 99%

Ten-Year Outcome after Rapid Discontinuation of Prednisone in Adult Primary Kidney Transplantation

Rizzari¹,

Suszynski²,

Gillingham³

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Rapid discontinuation of prednisone after kidney transplantation potentially allows for minimization of steroid-related side effects. Although intermediate-term data with rapid discontinuation of prednisone have been promising, concern still exists regarding long-term outcomes. The 10-year experience is reported herein.Design, setting, participants, & measurements Between October 1, 1999 and December 31, 2010, 1241 adult primary kidney transplants (791 living donor and 450 deceased donor) were performed using a protocol in which prednisone is discontinued after postoperative day 5. The 10-year actuarial recipient and graft survival rates and prednisone-related side effects were studied.Results Ten-year actuarial patient survival was 71% for living donor transplants and 62% for deceased donor transplants; 10-year graft survival was 61% for living donor transplants and 51% for deceased donor transplants, and was comparable to 10-year Scientific Registry of Transplant Recipients national data. Ten-year deathcensored graft survival was 79% for living donor transplants and 80% for deceased donor transplants. Ten-year acute rejection rates were 25% for deceased donor transplants and 31% for living donor transplants; 10-year chronic rejection (interstitial fibrosis/tubular atrophy) rates were 39% for deceased donor transplants and 47% for living donor transplants. For nondiabetic recipients of living donor or deceased donor allografts, the incidence of new-onset diabetes was significantly lower than in historical controls on prednisone (P,0.001). We also found significantly reduced rates of cataracts, avascular necrosis, and cytomegalovirus infection in some subgroups.Conclusions Prednisone-related side effects can be minimized in a protocol incorporating rapid discontinuation of prednisone for maintenance immunosuppression. Ten-year patient and graft outcomes remain acceptable.

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“…Mint minden szerv átül-tetésénél, a hasnyálmirigy-transzplantációnál is négy gyógyszercsoportból (kalcineurininhibitorok, antimetabolitok, szteroid és mTOR-inhibitorok) tetszőlegesen összeállított kombinációt választhatunk. A legtöbb hasnyálmirigy-transzplantációs program két kombináció valamelyikét választja [33]. Világszerte leggyakrabban a szteroid, tacrolimus, mycophenolat-mophetil kombinációt használják.…”

Section: Immunszuppresszióunclassified

Role of simultaneous pancreas-kidney transplantation in the treatment of diabetes mellitus

et al. 2013

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A veseelégtelenséggel szövődött 1-es típusú diabetes mellitus esetében a betegek életkilátása rosszabb, mint néhány rosszindulatú betegségben szenvedő betegé. A vesepótló kezelések minden formája közül a szimultán hasnyálmirigy-vese transzplantáció biztosítja a legjobb betegtúlélési eredményeket. A műtéti technika és az immunszuppressziós kezelés az elmúlt évtized során egyre inkább egységesült. Bár a transzplantálható szervek száma messze elmarad az igény mögött, a szimultán hasnyálmirigy-vese átültetés a legeredményesebb kezelési alternatívaként ajánlható az arra alkalmas betegeknek. A hazai két hasnyálmirigy-transzplantációs programban elvégzett több mint 100 szimultán hasnyálmirigy-vese transzplantáció eredményei összhangban vannak a nemzetközi eredményekkel. Orv. Hetil., 2013, 154, 850-856. Kulcsszavak: szimultán hasnyálmirigy-vese átültetés, 1-es típusú diabetes Role of simultaneous pancreas-kidney transplantation in the treatment of diabetes mellitusThe life expectancy of patients with type 1 diabetes mellitus is inferior to that of patients with some malignancies. Simultaneous pancreas-kidney transplantation is the procedure providing the best survival results among all options of renal replacement therapy. The operative techniques and immunosuppresion have been standardized in the last decade. Although the number of transplantable organs falls behind the need, simultaneous pancreas-kidney transplantation is the method of choice for the eligible patients. The results of the two Hungarian simultaneous pancreaskidney transplantation programs are in accordance with data published in the international literature. Orv. Hetil., 2013, 154, 850-856. Rövidítések ATG = anti thymocyta-globulin; CMV = cytomegalovirus; DCD = (donation after circulatory death) keringésmegszűnés utáni donáció; GFR = glomeruláris fi ltrációs ráta; HLA = humán leukocyta-antigén; KAP = (kidney after pancreas) = hasnyálmirigy-átültetés utáni vesetranszplantáció; mTOR = mammalian target of rapamycin; NHB = (non-heart beating) nem dobogó szívű; PAK = (pancreas after kidney) hasnyál-mirigy-átültetés veseátültetést követően; PTA = (pancreas transplant alone) szoliter hasnyálmirigy-átültetés; SPK = (simultaneous pancreas-kidney) szimultán hasnyálmirigy-vese transzplantáció; UW = University of Wisconsin

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Long-Term Renal Transplant Function in Recipient of Simultaneous Kidney and Pancreas Transplant Maintained With Two Prednisone-Free Maintenance Immunosuppressive Combinations: Tacrolimus/Mycophenolate Mofetil Versus Tacrolimus/Sirolimus

Abstract: Our data suggest that, in SPK recipients, long-term kidney allograft survival and function are not statistically different. A trend toward an increased rate of renal allograft loss was found in the Tac/SRL-treated group.

Cited by 43 publications

References 19 publications

Influence of donor- and recipient-specific factors on the postoperative course after combined pancreas–kidney transplantation

Influence of donor- and recipient-specific factors on the postoperative course after combined pancreas–kidney transplantation

Ten-Year Outcome after Rapid Discontinuation of Prednisone in Adult Primary Kidney Transplantation

Role of simultaneous pancreas-kidney transplantation in the treatment of diabetes mellitus

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