[논문]Immunosuppression in pancreas transplantation: progress, problems and perspective

doi:10.1016/S0966-3274(98)80020-8

[해외논문] Immunosuppression in pancreas transplantation: progress, problems and perspective

Transplant immunology, v.6 no.2, 1998년, pp.69 - 77

Stratta, Robert J (Address for correspondence: RJ Stratta, University of Tennessee-Memphis, Department of Surgery, 956 Court Avenue, Suite A202, Memphis, Tennessee 38163-2116, USA.)

Abstract ▼ AI-Helper

AbstractThrough 1997, over 10 000 pancreas transplants have been performed world-wide, with 88% being simultaneous kidney-pancreas transplants (SKPTs). Current 1-year patient survival exceeds 90% and pancreas graft survival (complete insulin independence) exceeds 80% for SKPT, 70% for sequential pancreas after kidney transplant (PAKT), and 65% for pancreas transplant alone (PTA). According to Registry data, rejection account for 32% of graft failures in the first year after pancreas transplantation. However, improving outcomes are expected to continue with the evolution of treatment protocols. Most pancreas transplant centres employ quadruple drug immunosuppression with anti-lymphocyte induction, using either a monoclonal or polyclonal antibody agent. In recent years, there has been an overall decline in the use of antibody-induction therapy from 90% during 1987–93, to 83% of pancreas transplants performed during 1994–97. Maintenance immunosuppression is triple therapy consisting of a calcineurin inhibitor (cyclosporine or tacrolimus), corticosteroids, and an anti-metabolite such as azathioprine (AZA) or mycophenolate mofetil (MMF). Prior to 1995, nearly all p ancreas transplant recipients were managed with Sandimmune. Since 1986, tacrolimus-based therapy has been used in approximately 20% of cases, and a new microemulsion formulation of cyclosporine (Neoral) has replaced Sandimmune in contemporary post-transplant immunosuppression. In addition, MMF is replacing AZA as part of the standard immunosuppressive regimen following pancreas transplantation. At present, a number of centres are conducting various trials with new drug combinations including either Neoral or tacrolimus in combination with steroids and MMF, with or without antibody-induction therapy. From 1994 to 1997, the 1-year rates of immunologic graft loss have decreased to 2% after SKPT, 9% after PAKT, and 16% after PTA. The current array of new immunosuppressive agents are providing more effective control of rejection and permitting solitary pancreas transplantation to become an accepted treatment option in diabetic patients without advanced complications. The apparent potency of new drug combinations has also resulted in a resurgence of interest in steroid withdrawal. Immunosuppressive strategies will continue to evolve to achieve effective control of rejection while minimizing injury to the allograft and risk to the patient. In addition, new regimens must not only address the issue of specific drug toxicities, but also long-term economic, metabolic, and quality of life outcomes. Pancreas transplantation will remain an important alternative in the treatment of diabetic patients until other strategies are developed that can provide equal glycaemic control with less immunosuppression and overall morbidity.

참고문헌 (67)

Annu Rev Med Stratta 46 281 1995 10.1146/annurev.med.46.1.281 Pancreas transplantation for diabetes mellitus

상세보기
Gruessner 47 1994 Pancreas transplantation in the United States (US) and non-US as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR)
Surgery Sollinger 102 674 1987 Pancreas transplantation with pancreaticocystostomy and quadruple immunosuppression
Transplant Proc Wadstrom 27 1317 1995 Triple versus quadruple induction immunosuppression in pancreas transplantation

상세보기
Transplant Proc Brayman 26 2525 1994 Is induction therapy necessary for successful simultaneous pancreas and kidney transplantation in the cyclosporine era?

상세보기
The International Congress on Immunosuppression, Orlando, Florida Cantarovich 11 1997 Randomized comparison of triple therapy versus anti-thymocyte globulin induction following combined pancreas-renal transplantation
Transplant Proc Stratta 26 546 1994 OKT3-induction in 100 consecutive pancreas transplants

상세보기
Transplant Proc Stratta 28 917 1996 A prospective randomized trial of OKT3 versus ATGAM-induction therapy in pancreas transplant recipients
Transplant Proc Knechtle 23 1581 1991 OKT3 versus ALG induction therapy in combined pancreas-kidney transplantation
Transplant Proc Ilner 22 1586 1990 Quadruple-drug induction therapy in combined renal and pancreatic transplantation: OKT3 versus ATG

상세보기
Transplant Proc Sutherland 26 2752 1994 Pancreas transplant outcome with or without biological anti-T cell therapy for induction immunosuppression with use of cyclosporine

상세보기
Clin Transplant Sutherland 5 549 1991 Immunosuppression for clinical pancreas transplantation
Transplant Proc Rosenberg 29 35S 1997 10.1016/S0041-1345(97)80010-3 Pancreas transplantation with ATG versus OKT3

상세보기
Transplant Proc Gruessner 26 437 1994 Assessment of donor and recipient risk factors on pancreas transplant outcome

상세보기
Transplant Proc Brayman 24 91 1992 Factors leading to improved outcome following pancreas transplantation - the influence of immunosuppression and HLA matching

상세보기
Transplant Proc Shapiro 27 3087 1995 Successful pancreas-renal transplantation without anti-T cell antibody induction

상세보기
Acta Diabetol Corry 34 125 1997 Tacrolimus without anti-lymphocyte induction therapy prevents pancreas loss from rejection in 100 consecutive patients
Transplantation Van Der Pijl 62 456 1996 10.1097/00007890-199608270-00006 Pharmacokinetics of the conventional and microemulsion formulations of cyclosporine in pancreas-kidney transplant recipients with gastroparesis

상세보기
Transplant Proc Storck 27 3094 1995 Cyclosporine resorption in diabetic patients after simultaneous pancreas and kidney transplantation

상세보기
Clin Transplant Lang 3 1 1989 Cyclosporine pharmacokinetics in diabetic patients after kidney and pancreas transplantation
Transplant Proc Serafinowicz 28 3140 1996 Cyclosporine pharmacokinetics in renal allograft recipients with diabetes mellitus treated with Sandimmune and Sandimmune Neoral
Transplant Proc Rigotti 29 2924 1997 10.1016/S0041-1345(97)00731-8 Neoral versus Sandimmune in kidney-pancreas transplantation

상세보기
Transplantation Chapman 61 1699 1996 10.1097/00007890-199606270-00006 Reversal of cyclosporine malabsorption in diabetic recipients of simultaneous pancreas and kidney transplants using a microemulsion formulation

상세보기
Transplant Proc Dawidson 27 134 1995 Cyclosporine blood levels predict the likelihood of rejection and toxicity after simultaneous pancreas-kidney transplantation
Transplantation Gruessner 61 261 1996 10.1097/00007890-199601270-00018 Multicentre analysis of the first experience with FK506 for induction and rescue therapy after pancreas transplantation

상세보기
Clin Transplant Gruessner 11 299 1997 Tacrolimus in pancreas transplantation: a multicentre analysis
Transplantation Hariharan 61 1161 1996 10.1097/00007890-199604270-00007 Rescue therapy with tacrolimus after combined kidney-pancreas and isolated pancreas transplantation in patients with severe cyclosporine nephrotoxicity

상세보기
Transplant Proc Stratta 28 991 1996 FK506 induction and rescue therapy in pancreas transplant recipients

상세보기
Transplant Proc Teraoka 27 1335 1995 Effect of rescue therapy using FK506 on relapsing rejection after combined pancreas and kidney transplantation

상세보기
Transplantation Shaffer 59 1063 1995 10.1097/00007890-199504150-00028 Normal pancreas allograft function following simultaneous pancreas kidney transplantation after rescue therapy with tacrolimus (FK506)

상세보기
Transplant Int Becker 10 51 1997 10.1111/j.1432-2277.1997.tb00536.x Rescue therapy with tacrolimus in simultaneous pancreas-kidney transplantation

상세보기
Transplant Proc Demirbas 29 2903 1997 10.1016/S0041-1345(97)00723-9 FK506 in simultaneous pancreas/kidney transplantation: The University of Miami experience

상세보기
Transplant Proc Alloway 28 995 1996 Conversion from cyclosporine to tacrolimus in kidney, kidney-pancreas, and pancreas alone transplant recipients: the Memphis experience

상세보기
Transplant Proc Burke 27 3123 1995 The use of FK506 in simultaneous pancreas/kidney transplantation: rescue, induction, and maintenance immunosuppression

상세보기
Acta Diabetol Peddi 34 162 1997 Use of tacrolimus-based immunosuppression eliminates acute rejection as a major complication following simultaneous kidney and pancreas transplantation
Ann Surg Bartlett 224 440 1996 10.1097/00000658-199610000-00003 Equivalent success of simultaneous pancreas-kidney and solitary pancreas transplantation. A prospective trial of tacrolimus immuno-suppression with percutaneous biopsy

상세보기
Transplantation Gruessner 64 1572 1997 10.1097/00007890-199712150-00011 Solitary pancreas transplantation for nonuremic patients with labile insulin-dependent diabetes mellitus

상세보기
Transplantation Sollinger 60 225 1995 10.1097/00007890-199508000-00003 Mycophenolate mofetil for the prevention of acute rejection in primary cadaveric renal allograft recipients

상세보기
Lancet 345 1321 1995 10.1016/S0140-6736(95)92534-1 Placebo-controlled study of mycophenolate mofetil combined with cyclosporine and corticosteroids for prevention of acute rejection

상세보기
American Society of Transplant Physicians, 15th Annual Scientific Meeting, Dallas, TX Stratta 26291996 Mycophenolate mofetil (MMF) induction and conversion therapy in pancreas transplant recipients
Acta Diabetol Elkhammas 34 161 1997 Combined kidney/pancreas transplantation: comparison of mycophenolate mofetil versus azathioprine
Transplantation Odorico 65 240(645A) 1998 10.1097/00007890-199805131-00642 A study comparing mycophenlate mofetil to azathioprine in simultaneous pancreas-kidney transplantation

상세보기
Acta Diabetol Gritsch 34 162 1997 Comparison of azathioprine and mycophenolate mofetil in pancreas transplantation
American Society of Transplant Physicians, 16th Annual Scientific Meeting. Chicago, IL Marcos 10141997 Mycophenolate mofetil is associated with decreased incidence of severity of acute cellular rejection following simultaneous kidney/pancreas transplant
Transplant Proc Stratta 29 654 1997 10.1016/S0041-1345(96)00383-1 Simultaneous use of tacrolimus and mycophenolate mofetil in combined pancreas-kidney transplant recipients: a multicentre report

상세보기
Acta Diabetol Gruessner 34 125 1997 Mycophenolate mofetil and tacrolimus in pancreas transplantation
Transplantation Stegall 64 1695 1997 10.1097/00007890-199712270-00011 Mycophenolate mofetil decreases rejection in simultaneous pancreas-kidney transplantation when combined with tacrolimus or cyclosporine

상세보기
Transplantation Reddy 65 251(691A) 1998 10.1097/00007890-199805131-00688 Simultaneous kidney-pancreas transplantation without anti-lymphocyte induction

상세보기
Acta Diabetol Bruce 34 161 1997 Effects of tacrolimus, mycophenolate mofetil, and microemulsified cyclosporine on rejection incidence in synchronous pancreas/kidney transplantation
Transplant Proc Burke 36 1544 1998 10.1016/S0041-1345(98)00350-9 The use of tacrolimus and mycophenolate mofetil for pancreas/kidney transplantation with or without OKT3 induction

상세보기
Acta Diabetol Busing 34 126 1997 Mycophenolate mofetil/tacrolimus/single shot ATG versus azathioprine/cyclosporine in pancreas-kidney transplantation: Results of a prospective randomized single-center study
Acta Diabetol Kaufman 34 120 1997 Results with tacrolimus/mycophenolate mofetil primary maintenance immunosuppression in simultaneous pancreas/kidney transplantation
Acta Diabetol Kahl 34 162 1997 First results with a quadruple therapy regimen including tacrolimus and mycophenolate mofetil in patients after combined pancreas and kidney transplantation
American Society of Transplant Surgeons, 23rd Annual Scientific Meeting, Chicago, IL Lee 14161997 FK506 and mycophenolate mofetil: the superior strategy for simultaneous pancreas-kidney patients
Transplant Immunol Zucker 5 225 1997 10.1016/S0966-3274(97)80042-1 Unexpected augmentation of mycophenolic acid pharmacokinetics in renal transplant patients receiving tacrolimus and mycophenolate mofetil in combination therapy, and analogous in vitro findings

상세보기
J Invest Med Larsen 42 622 1994 Consequences of pancreas transplantation
Curr Probl Surg Stratta 33 709 1996 10.1016/S0011-3840(96)80006-2 Pancreas transplantation: a managed cure approach to diabetes

상세보기
Transpl Proc Cantarovich 23 2224 1991 Maintenance immunosuppression without corticosteroids following combined pancreas and kidney transplantation
Transplantation Hricik 54 868 1992 10.1097/00007890-199211000-00019 The effects of steroid withdrawal on the lipoprotein in profiles of cyclosporine-treated kidney and kidney-pancreas transplant recipients

상세보기
Acta Diabetol Elmer 34 118 1997 Tacrolimus versus cyclosporin A: effects on glucose utilization in portally drained pancreas allografts
N Engl J Med Tyden 335 860 1996 10.1056/NEJM199609193351205 Recurrence of autoimmune diabetes mellitus in recipients of cadaveric pancreatic grafts

상세보기
Trans Assoc Am Physicians Sutherland 97 80 1984 Twin-to-twin pancreas transplantation: reversal and re-enactment of the pathogenesis of Type I diabetes

상세보기
Transplantation Larsen 56 1533 1993 Evidence that fasting hyperproinsulinemia after combined pancreas-kidney transplantation diminishes over time
Diabetes Diem 39 534 1990 10.2337/diabetes.39.5.534 Systemic venous drainage of pancreas allografts as independent cause of hyperinsulinemia in type I diabetic recipients

상세보기
Diabetes Care Milde 18 93 1995 10.2337/diacare.18.1.93 Pancreatic transplantation: impact on the quality of life of diabetic renal transplant recipients

상세보기
Transplant Proc Hathaway 27 3065 1995 Identification of quality-of-life outcomes distinguishing diabetic kidney-alone and pancreas-kidney recipients

상세보기
Diabetologica Zehrer 34 S145 1991 10.1007/BF00587643 Quality-of-life of pancreas transplant recipients

상세보기

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

[해외논문] Immunosuppression in pancreas transplantation: progress, problems and perspective

Abstract ▼ AI-Helper

참고문헌 (67)

이 논문을 인용한 문헌

관련 콘텐츠

원문 URL 링크

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트