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Rescue therapy with tacrolimus in simultaneous pancreas/kidney transplantation

  • Original Article
  • Published:
Transplant International

Abstract

Tacrolimus has been effective both in primary and rescue therapy following steroid and OKT3-resistant acute rejection in liver and kidney transplantation. Due to the effects of tacrolimus on glucose metabolism, there has been concern about its use in simultaneous pancreas/kidney transplantation. We report on the results of six patients (three female, three male, age 35.2 ± 7.3 years) converted from cyclosporin A to tacrolimus following simultaneous pancreas/kidney transplantation in steroid-resistant acute rejection. Tacrolimus was induced 2.8 ± 1.7 months (range 1–4.8 months) after transplantation; follow-up was 3–18 months. Following conversion, creatinine levels declined in all patients [3.5 ± 1.2 mg/dl before conversion, 3.0 ± 1.9 mg/dl (n = 6) at three months, 1.4 ± 0.1 mg/dl at 1 year (n = 3)]. Before conversion, fasting blood glucose levels averaged 154 ± 33 mg/dl, with three patients receiving insulin. Three months later no patient required insulin, the mean glucose level being 107 ± 23 mg/dl (n = 6); at 1 year it was 92 ± 9 mg/dl (n = 3). One patient lost his pancreatic graft after 4 months due to a mycotic aneurysm. We conclude that conversion to tacrolimus is a safe and effective treatment in cases of steroid-resistant rejections following pancreas/kidney transplantation.

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Authors and Affiliations

  1. Department of Nephrology IG1-9, University Hospital Essen, Hufelandstrasse 55, D-45122, Essen, Germany

    Gerold Becker, Oliver Witzke, Karl Wagner, Thomas Philipp & Uwe Heemann

  2. Department of Surgery, Universitiy Hospital Essen, Hufelandstrasse 55, D-45122, Essen, Germany

    Jürgen Friedrich & Karl-Heinz Albrecht

Authors
  1. Gerold Becker
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  2. Oliver Witzke
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  3. Jürgen Friedrich
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  4. Karl-Heinz Albrecht
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  5. Karl Wagner
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  6. Thomas Philipp
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  7. Uwe Heemann
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Becker, G., Witzke, O., Friedrich, J. et al. Rescue therapy with tacrolimus in simultaneous pancreas/kidney transplantation. Transplant Int 10, 51–54 (1996). https://doi.org/10.1007/BF02044342

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  • DOI: https://doi.org/10.1007/BF02044342

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