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Islet of langerhans allogeneic transplantation at the university of geneva in the steroid free era in islet after kidney and simultaneous islet-kidney transplantations

Berney, T. et al.

Transplantation proceedings. VOL 36; NUMBER 4, ; 2004, 1121-1122 -- Elsevier Science B.V., Amsterdam. (pages 1121-1122) -- 2004

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  • Title:
    Islet of langerhans allogeneic transplantation at the university of geneva in the steroid free era in islet after kidney and simultaneous islet-kidney transplantations
  • Author: Berney, T.;
    Bucher, P.;
    Mathe, Z.;
    Andres, A.;
    Bosco, D.;
    Mage, R.;
    Toso, C.;
    Oberholzer, J.;
    Becker, C.;
    Philippe, J.
  • Found In: Transplantation proceedings. VOL 36; NUMBER 4, ; 2004, 1121-1122
  • Journal Title: Transplantation proceedings.
  • Subjects: Medicine; LCC: RD120; Dewey: 617.95
  • Publication Details: Elsevier Science B.V., Amsterdam.
  • Language: English
  • Abstract: AimsWe 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.MethodsEight 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.ResultsFive 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.ConclusionsThe 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.
  • Identifier: Journal ISSN: 0041-1345
  • Publication Date: 2004
  • Physical Description: Electronic
  • Accrual Information: Quarterly
  • Shelfmark(s): 9025.100000
  • UIN: ETOCRN151051043

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