title: Pancreatic transplantation at the University of Pittsburgh.
abstract: Campath-1H preconditioning with tacrolimus monotherapy is an effective immunosuppressive regimen for pancreas transplantation, with acceptable patient and graft survival rates early after transplantation. Rejection rates are low under this protocol if the tacrolimus level is kept consistently >10 ng/ml. This immunosuppressive protocol, combined with recent technical refinements, has resulted in lower rates of thrombosis and overall complications. Pancreatic transplantation en-bloc with visceral grafts has the following unique features: Diabetes is a rare indication, and HLA matching is not required. The gland is immunologically protected by the simultaneously transplanted visceral organs. Disease gravity, surgical complexity and gut alloimmunity influence the overall pancreatic allograft survival. The current UNOS listing criteria and data registry should be modified for obvious logistic and scientific reasons.
authors.affiliation: The Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Ngoc L
authors.initials: NL
authors.lastname: Thai
authors.forename: Kareem
authors.initials: K
authors.lastname: Abu-Elmagd
authors.forename: Akhar
authors.initials: A
authors.lastname: Khan
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Bond
authors.forename: Amit
authors.initials: A
authors.lastname: Basu
authors.forename: Kusum
authors.initials: K
authors.lastname: Tom
authors.forename: George
authors.initials: G
authors.lastname: Mazariegos
authors.forename: Rakesh
authors.initials: R
authors.lastname: Sindhi
authors.forename: Jorge
authors.initials: J
authors.lastname: Reyes
authors.forename: Henkie P
authors.initials: HP
authors.lastname: Tan
authors.forename: Amadeo
authors.initials: A
authors.lastname: Marcos
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Starzl
authors.forename: Ron
authors.initials: R
authors.lastname: Shapiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D010179:Pancreas / Q000033:anatomy & histology / Q000601:surgery; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods* / Q000401:mortality; D010414:Pennsylvania / Q000453:epidemiology; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use; D014019:Tissue Donors; D019172:Transplantation Conditioning
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab; D016559:Tacrolimus