Pancreas Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Pancreas Transplant, including details on risks, prognosis, procedure, surgery, organ donation. | ||||||||
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The case for pancreas after kidney transplantation.Fridell JA, Mangus RS, Hollinger EF, Taber TE, Goble ML, Mohler E, Milgrom ML, Powelson JA Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA. jfridell@iupui.edu Pancreas after kidney (PAK) transplantation has historically demonstrated inferior pancreas allograft survival compared to simultaneous pancreas and kidney (SPK) transplantation. Under our current immunosuppression protocol, we have noted excellent outcomes and rare immunological graft loss. The goal of this study was to compare pancreas allograft survival in PAK and SPK recipients using this regimen. This was a single center retrospective review of all SPK and PAK transplants performed between January 2003 and November 2007. All transplants were performed with systemic venous drainage and enteric exocrine drainage. Immunosuppression included induction with rabbit anti-thymocyte globulin (thymoglobulin), early steroid withdrawal, and maintenance with tacrolimus and sirolimus or mycophenolate mofetil. Study end points included graft and patient survival and immunosuppression related complications. Transplants included PAK 61 (30%) and SPK 142 (70%). One-yr patient survival was PAK 98% and SPK 95% (p = 0.44) and pancreas graft survival was PAK 95% and SPK 90% (p = 0.28). Acute cellular rejection was uncommon with 2% requiring treatment in each group. Survival for PAK using thymoglobulin induction, early steroid withdrawal and tacrolimus-based immunosuppression is at least comparable to SPK and should be pursued in the recipient with a potential living donor. Published 17 August 2009 in Clin Transplant, 23(4): 447-53.
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