Immunosuppression for pancreatic islet transplantation

Berney, Thierry; Buehler, Leo Hans; Majno, Pietro; Mentha, Gilles; Morel, Philippe

doi:10.1016/j.transproceed.2003.12.035

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Title		Immunosuppression for pancreatic islet transplantation
Authors		Berney, Thierry Buehler, Leo Hans Majno, Pietro Mentha, Gilles Morel, Philippe
Published in		Transplantation Proceedings. 2004, vol. 36, no. 2 Suppl, p. 362S-366S
Abstract		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).
Keywords		Cyclosporine/therapeutic use — Drug Therapy, Combination — Humans — Immunosuppression/adverse effects/methods — Immunosuppressive Agents/therapeutic use — Islets of Langerhans Transplantation/immunology/pathology — Lymphocyte Depletion — Sirolimus/therapeutic use
Identifiers		DOI: 10.1016/j.transproceed.2003.12.035 PMID: 15041369
Full text		Article (Published version) (80 Kb) - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de chirurgie
Research groups		Hépatologie chirurgicale (327) Cultures cellulaires et transplantations (519) La transplantation d'îlots de Langerhans (623) Chirurgie viscérale (104) Chirurgie viscérale (HUG)
Citation (ISO format)		BERNEY, Thierry et al. Immunosuppression for pancreatic islet transplantation. In: Transplantation Proceedings, 2004, vol. 36, n° 2 Suppl, p. 362S-366S. doi: 10.1016/j.transproceed.2003.12.035 https://archive-ouverte.unige.ch/unige:37186