دورية أكاديمية
Glycemic Stability Through Islet-After-Kidney Transplantation Using an Alemtuzumab-Based Induction Regimen and Long-Term Triple-Maintenance Immunosuppression.
| العنوان: | Glycemic Stability Through Islet-After-Kidney Transplantation Using an Alemtuzumab-Based Induction Regimen and Long-Term Triple-Maintenance Immunosuppression. |
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| المؤلفون: | Nijhoff MF; Department of Medicine, Division of Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, the Netherlands.; Division of Nephrology and Transplantation, Leiden University Medical Centre, Leiden, the Netherlands., Engelse MA; Division of Nephrology and Transplantation, Leiden University Medical Centre, Leiden, the Netherlands., Dubbeld J; Departments of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Braat AE; Departments of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Ringers J; Departments of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Roelen DL; Immunohematology, Leiden University Medical Centre, Leiden, the Netherlands., van Erkel AR; Radiology, Leiden University Medical Centre, Leiden, the Netherlands., Spijker HS; Division of Nephrology and Transplantation, Leiden University Medical Centre, Leiden, the Netherlands., Bouwsma H; Division of Nephrology and Transplantation, Leiden University Medical Centre, Leiden, the Netherlands., van der Boog PJ; Division of Nephrology and Transplantation, Leiden University Medical Centre, Leiden, the Netherlands., de Fijter JW; Division of Nephrology and Transplantation, Leiden University Medical Centre, Leiden, the Netherlands., Rabelink TJ; Division of Nephrology and Transplantation, Leiden University Medical Centre, Leiden, the Netherlands., de Koning EJ; Department of Medicine, Division of Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, the Netherlands.; Division of Nephrology and Transplantation, Leiden University Medical Centre, Leiden, the Netherlands. |
| المصدر: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2016 Jan; Vol. 16 (1), pp. 246-53. Date of Electronic Publication: 2015 Aug 19. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 100968638 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1600-6143 (Electronic) Linking ISSN: 16006135 NLM ISO Abbreviation: Am J Transplant Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2023- : [New York] : Elsevier Original Publication: Copenhagen : Munksgaard International Publishers, 2001- |
| مواضيع طبية MeSH: | Glycemic Index* , Islets of Langerhans Transplantation* , Kidney Transplantation*, Antibodies, Monoclonal, Humanized/*therapeutic use , Diabetes Mellitus, Type 1/*surgery , Graft Rejection/*drug therapy , Immunosuppressive Agents/*therapeutic use, Alemtuzumab ; Anti-Inflammatory Agents/therapeutic use ; Antineoplastic Agents/therapeutic use ; Blood Glucose/metabolism ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Glucose Tolerance Test ; Graft Rejection/epidemiology ; Graft Survival ; Humans ; Kidney Function Tests ; Maintenance Chemotherapy ; Male ; Middle Aged ; Mycophenolic Acid/analogs & derivatives ; Mycophenolic Acid/therapeutic use ; Postoperative Complications ; Prednisolone/therapeutic use ; Prognosis ; Risk Factors ; Tacrolimus/therapeutic use |
| مستخلص: | Pancreatic islet transplantation is performed in a select group of patients with type 1 diabetes mellitus. Immunosuppressive regimens play an important role in long-term islet function. We aimed to investigate the efficacy of islet transplantation in patients with type 1 diabetes and a previous kidney transplantation using an alemtuzumab-based induction regimen and triple maintenance immunosuppression. Patients with type 1 diabetes, who had received a kidney transplant previously, were treated with alemtuzumab as induction therapy for their first islet transplantation and basiliximab induction therapy for subsequent islet transplantations. Maintenance immunosuppression consisted of triple immunosuppression (tacrolimus, mycophenolate mofetil, and prednisolone). Thirteen patients (age 50.9 ± 9.2 years, duration of diabetes 35 ± 9 years) received a total of 22 islet transplantations. One- and 2-year insulin independence was 62% and 42%, respectively; graft function was 100% and 92%, respectively. HbA1c dropped from 57.2 ± 13.1 (7.4 ± 1.2%) to 44.5 ± 11.8 mmol/molHb (6.2 ± 0.9%) (p = 0.003) after 2 years. Six of 13 patients suffered from severe hypoglycemia before islet transplantation. After transplantation, severe hypoglycemia was restricted to the only patient who lost graft function. Creatinine clearance was unchanged. Islet-after-kidney transplantation in patients with type 1 diabetes using an alemtuzumab-based induction regimen leads to considerable islet allograft function and improvement in glycemic control. (© Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.) |
| المشرفين على المادة: | 0 (Anti-Inflammatory Agents) 0 (Antibodies, Monoclonal, Humanized) 0 (Antineoplastic Agents) 0 (Blood Glucose) 0 (Immunosuppressive Agents) 3A189DH42V (Alemtuzumab) 9PHQ9Y1OLM (Prednisolone) HU9DX48N0T (Mycophenolic Acid) WM0HAQ4WNM (Tacrolimus) |
| تواريخ الأحداث: | Date Created: 20150820 Date Completed: 20161025 Latest Revision: 20230124 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1111/ajt.13425 |
| PMID: | 26288226 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1600-6143 |
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| DOI: | 10.1111/ajt.13425 |