Simultaneous Islet and Kidney Transplantation in Seven Patients with Type 1 Diabetes and End-stage Renal Disease Using a Glucocorticoid-free Immunosuppressive Regimen with Alemtuzumab Induction

Overview

Journal Diabetes

Specialty Endocrinology

Date 2008 Jul 18

PMID 18633105

Citations 9

Authors

Jianming Tan

Shunliang Yang

Jinquan Cai

Junqi Guo

Lianghu Huang

Zhixian Wu

Jin Chen

Lianming Liao

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to evaluate the efficiency and safety of simultaneous islet and kidney transplantation in patients with type 1 diabetes and end-stage renal disease using a glucocorticoid-free immunosuppressive regimen with alemtuzumab induction.

Research Design And Methods: Seven patients with type 1 diabetes and end-stage renal failure were transplanted with allogenic islets and kidneys procured from brain-dead donors. To prevent organ rejection, patients received alemtuzumab for induction immunosuppression, followed by sirolimus and tacrolimus. No glucocorticoids were given at any time.

Results: The median duration of follow-up was 18.3 months (range 13-31). Kidney survival was 100%. Four patients became insulin independent at 1 year. The other three reduced insulin use to less than 25% of the amount required before transplantation. Serum C-peptide levels were significantly greater posttransplant in all patients, indicating continued islet function. No major procedure-related complications were observed.

Conclusions: Our results demonstrate that a steroid-free immunosuppressive regimen consisting of alemtuzumab, sirolimus, and tacrolimus is feasible for simultaneous islet and kidney transplantation. The question of whether this induction regimen is superior to more standard induction deserves large studies.

Citing Articles

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Immunosuppression With CD40 Costimulatory Blockade Plus Rapamycin for Simultaneous Islet-Kidney Transplantation in Nonhuman Primates.

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