[Kidney-pancreas transplantation. Clinical results in 23 consecutive patients].
Immunosuppressive approaches to combined kidney-pancreas tx include quadruple therapy with either antilymphocyte globulin (ATG) or OKT3 for a short period (7-14 days) immediately after transplantation. Maintenance therapy with prednisone, azathioprine and cyclosporin is then used to ensure the long-term survival of the graft. This study reports 23 cases of combined kidney-pancreas tx under ATG induction (n = 7) and OKT3 induction (n = 16). Both groups had maintenance therapy with azathioprine, prednisone and cyclosporin. The follow-up was 12 months. Graft loss was 3 out of 7 vs 1 out of 16 (p < 0.05) for the kidney and 3 out of 7 vs 3 out of 16 for the pancreas in ATG treated vs OKT3 treated patients respectively. There were two deaths in the ATG group and one in the OKT3 group; two patients died with functioning graft, one in each group. The one year actuarial survival was 87% for graft and patient, 83% for kidney and 77% for pancreas. Combined kidney-pancreas tx with ATG or OKT3 have a similar outcome. OKT3 allows a longer period before the onset of rejection. There is a trend in survivals which suggests a better survival in OKT3 treated recipients. Infections and other complications were similar in ATG and OKT3 patients.
Maestri
M
M
Department of Surgery, University of Stanford, USA.
Krieger
N
N
Kuo
P
P
Dafoe
D C
DC
Alfrey
E J
EJ
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D001379:Azathioprine / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016853:Muromonab-CD3 / Q000008:administration & dosage; D016035:Pancreas Transplantation / Q000401:mortality; D011241:Prednisone / Q000008:administration & dosage; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone
Il trapianto di rene-pancreas. Risultati clinici su 23 pazienti consecutivi.