Immunosuppression in pancreas transplantation: mycophenolate mofetil versus sirolimus

Immunosuppression in pancreas transplantation: mycophenolate mofetil versus sirolimus

The use of mycophenolate mofetil (MMF) in pancreas transplantation has increased graft survival and decreased the incidence of acute rejections episodes (ARE), regardless of the choice of calcineurin inhibitor. The combination of MMF with tacrolimus (TAC) is the most common protocol, it is considere...

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Published in:Transplantation proceedings Vol. 36; no. 4; pp. 975 - 977
Main Authors: Garcia, V.D, Keitel, E, Santos, A.F, Bianco, P.D, Bittar, A.E, Bruno, R.M, Garcia, C.D, Vitola, S.P, Guerra, E.E, Didone, E, Pires, F, D'Avila, A.J, Goldani, J.J, Bianchini, J.J
Format: Journal Article Conference Proceeding
Language:English
Published: New York, NY Elsevier Inc 01-05-2004
Elsevier Science
Subjects:
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiviral agents
Biological and medical sciences
Humans
Immunosuppression - methods
Immunosuppressive Agents - therapeutic use
Medical sciences
Mycophenolic Acid - analogs & derivatives
Mycophenolic Acid - therapeutic use
Pancreas Transplantation - immunology
Pharmacology. Drug treatments
Sirolimus - therapeutic use
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Antineoplastic agent
Mofetil
Mycophenolic acid
Sirolimus
Transplantation
Homotransplantation
Macrolide
Antibiotic
Immunosuppression
Treatment
Surgery
Antiviral
Graft
Immunosuppressive agent
Mycophenolate mofetil
Antibacterial agent
Pancreas
Comparative study
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Summary:The use of mycophenolate mofetil (MMF) in pancreas transplantation has increased graft survival and decreased the incidence of acute rejections episodes (ARE), regardless of the choice of calcineurin inhibitor. The combination of MMF with tacrolimus (TAC) is the most common protocol, it is considered the gold standard for new protocols. In the last few years, there have been reports of a small number of patients treated with sirolimus (RAPA), usually combined with TAC. Patient and pancreas survival rates as well as the incidence of ARE were similar to protocols with TAC and MMF. Twenty simultaneous pancreas and kidney (SPK) transplantations were performed using an immunosuppressive protocol of TAC, RAPA, and steroids (STE) after 2000. The incidence of ARE was 25%; all episodes responded to STE. Only 2 patients (10%) displayed hypercholesterolemia requiring treatment with statins. The use of RAPA as an alternative to MMF is promising, although presently one with limited experience. The combination of MMF and RAPA with or without a calcineurin inhibitor is an option to be evaluated in the future.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2004.04.003