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Immunosuppression for pancreatic islet transplantation

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 useDrug Therapy, CombinationHumansImmunosuppression/adverse effects/methodsImmunosuppressive Agents/therapeutic useIslets of Langerhans Transplantation/immunology/pathologyLymphocyte DepletionSirolimus/therapeutic use
PMID: 15041369
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Research groups Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
Cultures cellulaires et transplantations (519)
Hépatologie chirurgicale (327)
La transplantation d'îlots de Langerhans (623)
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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

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Deposited on : 2014-06-04

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