Successful pancreas-renal transplantation without induction therapy

Most pancreas transplant centers initially use immunosuppression with antilymphocyte induction because the pancreas appears to be a highly immunogeneic organ. Although the addition of an antilymphocyte agent provides enhanced immunosuppression in the early posttransplant period, it is associated with added costs and adverse reactions. In this study we evaluated the safety and efficacy of tacrolimus (Tac), mycophenolate mofetil (MMF), and steroid immunosuppression without induction after simultaneous kidney-pancreas transplantation (SKPT). Six patients (30%) displayed rejection episodes with a mean follow-up of 12 months (range = 4 to 18 months). No graft was lost due to rejection. The results of this series suggest that SKPT can be safely performed without induction therapy.