[Analysis of rejection after simultaneous pancreas-kidney transplantation].
OBJECTIVE
To explore methods of preventing and reversing rejection after simultaneous pancreas-kidney transplantation (SPK).


METHODS
Seventeen patients performed SPK operation from Sep, 1999 to Sep, 2003 were reviewed retrospectively. Immunosuppression was achieved by triple regimen consisting of cyclosporine, mycophenolate mofetil (MMF)/azathioprine and steroid. 2 patients were treated with Dalizumab, the other three patients used OKT3 as immune induction.


RESULTS
1 patient experienced the accelerated rejection, the pancreas and kidney grafts were resected because of failure of conservative therapy. 8 patients experienced renal acute rejection, 2 cases suffered from pancreas acute rejection at the same time. All these patients received daily high dose pulse steroid for 3 days. OKT3 was administered in 2 patients with steroid resistance rejection. All the grafts were successfully rescued.


CONCLUSIONS
Reasonable application of immunosuppression after SPK operation and adoption of systemic measures which can reduce sensitivity of high risk receptor before SPK operation are the effective methods of preventing and treating rejection.
Yang
Lei
L
Department of Transplantation, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
Liu
Yong-Feng
YF
Liu
Shu-Rong
SR
Liang
Jian
J
Cui
Hong
H
Meng
Yi-Man
YM
Wu
Gang
G
Li
Gui-Chen
GC
D000284:Administration, Oral; D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage; D003928:Diabetic Nephropathies / Q000601:surgery*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000276:immunology; D011239:Prednisolone / Q000008:administration & dosage; D012189:Retrospective Studies; D014184:Transplantation, Homologous
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D001379:Azathioprine