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Successful Simultaneous Islet‐Kidney Transplantation using a Steroid‐free Immunosuppression: Two‐Year Follow‐up
Author(s) -
Lehmann Roger,
Weber Markus,
Berthold Peter,
Züllig Richard,
Pfammatter Thomas,
Moritz Wolfgang,
Mädler Kathrin,
Donath Marc,
Ambühl Patrice,
Demartines Nicolas,
Clavien and PierrAlain,
Andreia Spinas Giatgen
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2004.00468.x
Subject(s) - medicine , immunosuppression , daclizumab , transplantation , urology , kidney transplantation , tacrolimus , creatinine , diabetes mellitus , renal function , kidney , islet , gastroenterology , surgery , endocrinology
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 m 2 , respectively. Five out of six patients with ≥ 2 islet transplantations became insulin independent. The mean HbA 1c 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.