Thymoglobulin Versus Basiliximab Induction Therapy for Simultaneous Kidney-Pancreas Transplantation: Impact on Rejection, Graft Function, and Long-Term Outcome

Bazerbachi, Fateh; Selzner, Markus; Boehnert, Markus; Marquez, Max; Norgate, Andrea; McGilvray, Ian; Schiff, Jeffrey; Cattral, Mark S.

doi:10.1097/tp.0b013e3182313e4f

Cited by 42 publications

(31 citation statements)

References 14 publications

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“…Now, few studies have been published comparing these drugs. Bazerbachi et al found identical 1-year, 3-year, and 5-year pancreas survival rates between basiliximab and ATG (93% versus 90%, 89% versus 87%, and 83% versus 78%, respectively) [5]. Similarly, in our institution, no difference was detected in pancreas graft survival after 1, 3, and 5 years.…”

Section: Discussionsupporting

confidence: 66%

Induction Therapy in Simultaneous Pancreas-Kidney Transplantation: Thymoglobulin Versus Basiliximab

Fernández-Burgos

Casado

Pérez-Daga

et al. 2015

Transplantation Proceedings

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Section: Discussionsupporting

confidence: 66%

Induction Therapy in Simultaneous Pancreas-Kidney Transplantation: Thymoglobulin Versus Basiliximab

Fernández-Burgos

Casado

Pérez-Daga

et al. 2015

Transplantation Proceedings

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“…Prednisone was used in pancreas transplant recipients, but since it could be tapered off in most patients during the first 2-3 years of follow-up or at least could be reduced to low dosages, a relevant impact on glycemic control is unlikely. Published data on induction therapy suggest that induction therapy with thymoglobulin is superior compared with other options (17,18). In our cohort, thymoglobulin induction therapy was only started in 2012; therefore, protocol changes in induction therapy were not influencing long-term outcome.…”

Section: Discussionmentioning

confidence: 78%

“…Induction therapy was performed initially with basiliximab (Novartis Pharma, Basel, Switzerland), and after 2012 with thymoglobulin (Sanofi, Paris, France) (17). Target long-term trough levels for tacrolimus were 10-15 mg/L.…”

Section: Immunosuppressionmentioning

confidence: 99%

Glycemic Control in Simultaneous Islet-Kidney Versus Pancreas-Kidney Transplantation in Type 1 Diabetes: A Prospective 13-Year Follow-up

Lehmann¹,

Graziano²,

Brockmann

et al. 2015

Diabetes Care

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OBJECTIVEIn patients with type 1 diabetes and end-stage renal disease, combined transplantation of a kidney together with a pancreas or isolated pancreatic islets are options to improve glycemic control. The aim of this study was to compare their long-term outcome with regard to metabolic control and surgical complication rate, as well as function of the transplanted kidney. RESEARCH DESIGN AND METHODSWe conducted a prospective cohort study in consecutive patients receiving either a pancreas or islet transplant simultaneously with or after kidney transplantation (simultaneous pancreas-kidney [SPK]/pancreas-after-kidney [PAK] or simultaneous islet-kidney [SIK]/islet-after-kidney [IAK] transplantation). RESULTSNinety-four patients who had undergone SPK/PAK transplantation were compared with 38 patients who had undergone SIK/IAK transplantation over a period of up to 13 years. HbA 1c levels declined from 7.8 6 1.3% (62 6 14 mmol/mol) to 5.9 6 1.1% (41 6 12 mmol/mol), and from 8.0 6 1.3% (64 6 14 mmol/mol) to 6.5 6 1.1% (48 6 12 mmol/mol), respectively, in the SPK/PAK and SIK/IAK groups (P < 0.001 for both) and remained stable during follow-up, despite a reduction in the rate of severe hypoglycemia by >90%. The 5-year insulin independence rate was higher in the SPK/PAK group (73.6 vs. 9.3% in the SIK/IAK group), as was the rate of relaparotomy after transplantation (41.5 vs. 10.5% in the SIK/IAK group). There was no difference in the rate of kidney function decline. CONCLUSIONSDuring a long-term follow-up, SPK/PAK transplantation as well as SIK/IAK transplantation resulted in a sustained improvement of glycemic control with a slightly higher glycated hemoglobin level in the SIK/IAK group. While insulin independence is more common in whole-organ pancreas recipients, islet transplantation can be conducted with a much lower surgical complication rate and no difference in kidney function decline.

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“…Az Amerikai Egyesült Államokban 2007-ben az összes átültetett hasnyálmirigy 8,8%-a 2-es típusú cukorbetegbe került [9,10]. Nem egy esetben előfordul, hogy csak a C-peptid-mérés képes különbséget tenni az 1-es és 2-es típusú cukorbetegség között, mert egyébként a klinikai kép nagyon hasonló lehet mindkét típus esetében [11].…”

Section: Indikációunclassified

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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Thymoglobulin Versus Basiliximab Induction Therapy for Simultaneous Kidney-Pancreas Transplantation: Impact on Rejection, Graft Function, and Long-Term Outcome

Abstract: ATG versus basiliximab induction therapy results in decreased acute cellular rejection in the first year after SPK with similar side effects. Long-term graft function and survival are not affected by induction regimen.

Cited by 42 publications

References 14 publications

Induction Therapy in Simultaneous Pancreas-Kidney Transplantation: Thymoglobulin Versus Basiliximab

Induction Therapy in Simultaneous Pancreas-Kidney Transplantation: Thymoglobulin Versus Basiliximab

Glycemic Control in Simultaneous Islet-Kidney Versus Pancreas-Kidney Transplantation in Type 1 Diabetes: A Prospective 13-Year Follow-up

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

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