LONG-TERM RESULTS OF PANCREAS TRANSPLANTATION UNDER TACROLIMUS IMMUNOSUPPRESSION

摘要: Background The long-term safety and efficacy of tacrolimus in pancreas transplantation has not yet been demonstrated. observation prolonged pancreatic graft function under would indicate that any potential islet toxicity is short-lived clinically insignificant. We report herein the results patients receiving primary immunosuppression for a minimum 2 years. Methods. From July 4, 1994 until April 18, 1996, 60 received either simultaneous pancreas-kidney transplant (n=55), only (n=4), or after kidney (n=1). Baseline consisted steroids without antilymphocyte induction. Azathioprine was used as third agent 51 mycophenolate mofetil 9. Rejection episodes within first 6 months occurred 48 (80%) were treated with high-dose corticosteroids. Antilymphocyte antibody required eight (13%) steroid-resistant rejection. Results. With mean follow-up 35.1±5.9 (range: 24.3-45.7 months), 6-month 1-, 2-, 33-year survival 88%, 82%, 80%, 80% (pancreas) 98%, 96%, 93%, 91% (kidney), respectively. Six-month 3-year patient 100%, 96.5%. Mean fasting glucose 91.6±13.8 mg/dl, glycosylated hemoglobin 5.1±0.7% (normal range: 4.3-6.1%). dose 6.5±2.6 mg/day prednisone 2.0±2.9 at follow-up. Complete steroid withdrawal possible 31 (65%) functioning pancreases. Conclusions. These data show time safe effective provides excellent evidence while permitting majority patients.