Minimization protocols in pancreas transplantation.

摘要: Diagnosis of immunologic injury (acute and chronic) is much more difficult in pancreas transplants when compared with other organs. Currently, the immunosuppressive regimen for induction involves calcineurin inhibitors (CNI), antimetabolites corticosteroids (Cs). This strong nonspecific does not take into consideration specificities (i.e. need to avoid diabetogenic compounds). For obvious reasons, CNI might be calling review, if permanently indicated recipients solitary mild renal dysfunction. as well may induce hyperglycemia contribute differential diagnosis a rejection process. However, spite benefits accruing from withdrawal above agents, minimization or avoidance these drugs could dangerous end up graft loss antibody-mediated process). Long-term results transplantation are now achieving comparable survival rates similar transplant traditional organs such kidney liver. As consequence, physicians' objectives prolong patient's quality life organ function long possible. Weaning strategies regard steroids tested. Sirolimus, everolimus, CTLA-4 Ig, etc, agents known either both nonnephrotoxic nondiabetogenic less so CNI. Their impact on beginning evaluated. Large randomized trials all categories, long-term clinical histologic results, mandatory establish new guidelines regimens transplantation.