Rescue therapy with tacrolimus in simultaneous pancreas/kidney transplantation |
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Authors: | Gerold Becker Oliver Witzke Jürgen Friedrich Karl-Heinz Albrecht Karl Wagner Thomas Philipp Uwe Heemann |
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Institution: | Department of Nephrology IG1-9, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany Fax: + 49 201 325 456;Department of Surgery, Universitiy Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany |
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Abstract: | Abstract Tacrolimus has been effective both in primary and rescue therapy following steroid and OKT3-resistant acute rejection in liver and kidney transplantation. Due to the effects of tacrolimus on glucose metabolism, there has been concern about its use in simultaneous pancreas/kidney transplantation. We report on the results of six patients (three female, three male, age 35.2 ± 7.3 years) converted from cyclosporin A to tacrolimus following simultaneous pancreas/kidney transplantation in steroid-resistant acute rejection. Tacrolimus was induced 2.8 ± 1.7 months (range 1–4.8 months) after transplantation; follow-up was 3–18 months. Following conversion, creatinine levels declined in all patients 3.5 ± 1.2 mg/dl before conversion, 3.0 ± 1.9 mg/dl ( n = 6) at three months, 1.4 ± 0.1 mg/dl at 1 year (n = 3)]. Before conversion, fasting blood glucose levels averaged 154 ± 33 mg/dl, with three patients receiving insulin. Three months later no patient required insulin, the mean glucose level being 107 ± 23 mg/dl ( n = 6); at 1 year it was 92 ± 9 mg/dl ( n - 3). One patient lost his pancreatic graft after 4 months due to a mycotic aneurysm. We conclude that conversion to tacrolimus is a safe and effective treatment in cases of steroid-resistant rejections following pancreas/kidney transplantation. |
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Keywords: | Rescue therapy tacrolismus kidney/pancreas transplantation Tacrolimus kidney/pancreas transplantation Kidney/pancreas transplantation rescue therapy Pancreas/kidney transplantation tacrolismus rescue therapy |
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