Successful Simultaneous Islet-Kidney Transplantation using a Steroid-free Immunosuppression: Two-Year Follow-up

    loading  Checking for direct PDF access through Ovid

Abstract

We report on the feasibility of a glucocorticoid-free immunosuppression (sirolimus, low-dose tacrolimus, and daclizumab) in simultaneous islet-kidney transplantation in nine patients with type 1 diabetes. There was one renal primary nonfunction. Renal function (n = 8) as assessed by creatinine and creatinine clearance over time was 103 ± 6 μmol/L and 64 ± 6 mL/min/1.73 m2, respectively. Five out of six patients with ≥ 2 islet transplantations became insulin independent. The mean HbA1c during the follow-up period for all patients after transplantation is 6.2 ± 0.9% as compared with 8.7 ± 1.9% prior to transplant. These results in patients with a median follow-up of 2.3 years suggest that kidney transplantation under a glucocorticoid-free immunosuppression is feasible, and that the rate of insulin independence of 80% can be achieved not only in patients with no or minimal diabetes complications, but also in patients with more advanced late complications and in conjunction with kidney transplantation.

Related Topics

    loading  Loading Related Articles