Comparison of sirolimus alone with sirolimus plus tacrolimus in type 1 diabetic recipients of cultured islet cell grafts
| Autor: | Chantal Mathieu, Zhidong Ling, Pieter Gillard, Bart Maes, Daniel Pipeleers, Bart Keymeulen, Bart O. Roep, Frans Gorus, Matthias Lannoo, Laurent Crenier |
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| Přispěvatelé: | Internal Medicine, Clinical Biology, Pathologic Biochemistry and Physiology, Faculty of Sciences and Bioengineering Sciences, Diabetes Clinic, Internal Medicine Specializations |
| Rok vydání: | 2008 |
| Předmět: |
Male
Postoperative Complications/pathology Cell Transplantation/adverse effects Cell Transplantation Endocrinology Diabetes and Metabolism Islets of Langerhans Transplantation Postoperative Complications Albuminuria/epidemiology Kidney transplantation Antibacterial agent Graft Survival/immunology Proteinuria C-Peptide Graft Survival Middle Aged Islets of Langerhans/cytology surgical procedures operative C-Peptide/blood Sirolimus/therapeutic use Drug Therapy Combination Female medicine.symptom Immunosuppressive Agents medicine.drug Adult Tacrolimus/therapeutic use medicine.medical_specialty Combination therapy Urology Tacrolimus Islets of Langerhans Internal medicine medicine Albuminuria Humans Lymphocyte Count Autoantibodies Sirolimus Transplantation business.industry Islets of Langerhans Transplantation/adverse effects medicine.disease Calcineurin Endocrinology Diabetes Mellitus Type 1 Diabetes Mellitus Type 1/surgery Immunosuppressive Agents/therapeutic use Autoantibodies/blood business |
| Zdroj: | Transplantation. 85(2) |
| ISSN: | 0041-1337 |
| Popis: | Background. One year survival of islet cell grafts has been reproducibly achieved under combination immune therapy including tacrolimus (TAC). However, the use of TAC causes beta-cell and renal toxicity. Because sirolimus (SIR) monotherapy was successful in kidney transplantation under antithymocyte globulin (ATG), we undertook a pilot study comparing SIR monotherapy with SIR-TAC combination therapy. Methods. Nonuremic type 1 diabetics received a cultured beta-cell graft under ATG and were randomly assigned to SIR or SIR-TAC-maintenance therapy; a second graft was implanted during posttransplantation month 3 without ATG. The planned number of patients per group (n= 10) was reduced to five in view of the observed side effects. Results. At posttransplant month 6, three SIR-patients had lost graft function and two presented marginal function; among SIR-TAC-patients, there were two early graft failures but three became insulin-independent. These three patients maintained metabolically relevant function (C-peptide > 1 ng/ml and coefficient of variation fasting glycemia |
| Databáze: | OpenAIRE |
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