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SHR Neuro Cancer Cardio Lipid Metab Microb

Berney, T; Bucher, P; Mathe, Z; Andres, A; Bosco, D; Mage, R; Toso, C; Oberholzer, J; Becker, C; Philippe, J; Bühler, L; Morel, P.
Islet of Langerhans allogeneic transplantation at the University of Geneva in the steroid free era in islet after kidney and simultaneous islet-kidney transplantations.
Transplant Proc. 2004; 36(4):1121-1122 Doi: 10.1016/j.transproceed.2004.04.027
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Co-authors Med Uni Graz: Mathe Zoltan
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Abstract:: We report a single-center experience of islet allogeneic transplantation in islet after kidney (IAK) and simultaneous islet-kidney (SIK) type 1 diabetic recipients using a steroid-free immunosuppressive regimen. Eight patients received 12 islet infusions in 5 IAK and 3 SIK procedures. Median age was 51 years (range, 30-58 years) with a male:female ratio of 2:6. IAK was considered only for patients with a stable kidney function and a creatinine clearance level >60 mL/min. SIK was considered for patients with a counterindication for simultaneous kidney-pancreas transplantation. Immunosuppression was based on sirolimus/tacrolimus combined with daclizumab induction. Two consecutive infusions of >5000 islet equivalents (IEQ)/kg were planned. Five patients completed the transplantation course, whereas 3 patients received only 1 islet infusion. All patients have functional grafts (C-peptide >166 pmol/L) at 6-month median follow-up. Of 5 patients who completed their transplantation course 4 became insulin independent. HbA1c and fructosamine decreased over time, showing improved metabolic control. Severe adverse events were observed in 4 patients. One SIK patient died after OKT-3 treatment of severe kidney rejection. The Edmonton immunosuppressive protocol can be applied for patients undergoing either IAK or SIK procedures, with a high rate of graft function and insulin independence. Morbidity is higher than among patients undergoing solitary islet transplantation for type 1 brittle diabetes.
Find related publications in this database (using NLM MeSH Indexing): Adult -; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized -; Daclizumab -; Female -; Follow-Up Studies -; Humans -; Immunoglobulin G - therapeutic use; Immunosuppressive Agents - therapeutic use; Islets of Langerhans Transplantation - physiology; Kidney Transplantation - physiology; Male -; Middle Aged -; Sirolimus - therapeutic use; Switzerland -; Tacrolimus - therapeutic use; Treatment Outcome -