Faculty Collaboration Database

Prospective, randomized, multi-center trial of antibody induction therapy in simultaneous pancreas-kidney transplantation. Am J Transplant 2003 Jul;3(7):855-64

Date

06/20/2003

Pubmed ID

12814477

DOI

10.1034/j.1600-6143.2003.00160.x

Scopus ID

2-s2.0-10744221396 (requires institutional sign-in at Scopus site)   54 Citations

Abstract

A randomized, multicenter, prospective study was conducted at 18 pancreas transplant centers in the United States to determine the role of induction therapy in simultaneous pancreas-kidney (SPK) transplantation. One hundred and 74 recipients were enrolled: 87 recipients each in the induction and noninduction treatment arms. Maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil, and corticosteroids. There were no statistically significant differences between treatment groups for patient, kidney, and pancreas graft survival at 1-year. The 1-year cumulative incidence of any treated biopsy-confirmed or presumptive rejection episodes (kidney or pancreas) in the induction and noninduction treatment arms was 24.6% and 31.2% (p = 0.28), respectively. The 1-year cumulative incidence of biopsy-confirmed, treated, acute kidney allograft rejection in the induction and noninduction treatment arms was 13.1% and 23.0% (p = 0.08), respectively. Biopsy-confirmed kidney allograft rejection occurred later post-transplant and appeared to be less severe among recipients that received induction therapy. The highest rate of Cytomegalovirus (CMV) viremia/syndrome was observed in the subgroup of recipients who received T-cell depleting antibody induction and received organs from CMV serologically positive donors. Decisions regarding the routine use of induction therapy in SPK transplantation must take into consideration its differential effects on risk of rejection and infection.

Author List

Kaufman DB, Burke GW III, Bruce DS, Johnson CP, Gaber AO, Sutherland DE, Merion RM, Gruber SA, Schweitzer E, Leone JP, Marsh CL, Alfrey E, Concepcion W, Stegall MD, Schulak JA, Gores PF, Benedetti E, Smith C, Henning AK, Kuehnel F, King S, Fitzsimmons WE

Author

Christopher P. Johnson MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Antibodies
Graft Rejection
Humans
Immunization, Passive
Immunosuppressive Agents
Kidney Transplantation
Lymphocytes
Pancreas Transplantation