Immunosuppression for pancreatic islet transplantation

被引：29

作者：

Berney, T ^{[1
]}

Buhler, LH ^{[1
]}

Majno, P ^{[1
]}

Mentha, G ^{[1
]}

Morel, P ^{[1
]}

机构：

[1] Univ Hosp Geneva, Dept Surg, Div Visceral & Transplantat Surg, CH-1211 Geneva, Switzerland

来源：

TRANSPLANTATION PROCEEDINGS | 2004年 / 36卷 / 02期

关键词：

D O I：

10.1016/j.transproceed.2003.12.035

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Protocols for islet transplantation have to take into account the diabetogenicity/islet toxicity of the immunosuppressive agents, namely corticosteroids and calcineurin inhibitors, most notably tacrolimus. The development by the Edmonton group of a sirolimus-based, steroid-free, low-tacrolimus regimen was a significant breakthrough that allowed the rate of insulin independence after islet transplantation to increase from 13% to 80% at 1 year. Drawbacks include the side effects of sirolimus and the reduction in insulin independence to 50% at 3 years, the latter being attributed to prolonged tacrolimus exposure. Currently explored alternatives to tacrolimus include cyclosporine, mycophenolate mofetil, and the novel agent FTY 720. Perspectives for the near future involve the achievement of "prope tolerance" by strategies using lymphocyte-depleting antibodies (anti-thymocyte globulin, campath-1H, hOKT3gamma1 [ala,ala]), or costimulatory blockade (anti-CD154 mAbs, CTLA4-Ig).

引用

页码：362S / 366S

页数：5

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