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Current Opinion in Organ Transplantation:
doi: 10.1097/MOT.0b013e328012e3b8
Pancreas transplantation

Novel immunosuppression in pancreas transplantation and outcomes

Axelrod, Davida; Kaufman, Dixon Bb

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Abstract

Purpose of review: Pancreas transplantation continues to evolve and mature offering diabetic patients longer lives with improved quality of life and reduced morbidity. A review of current literature was performed to assess important trends in the care and outcome of patients following pancreas transplantation with and without simultaneous renal transplant.

Recent findings: Overall results of pancreas transplantation have improved worldwide. Since 1988, 1-year survival pancreas graft survival rates have improved from 75 to 85% for simultaneous kidney–pancreas transplants, 55 to 78% for pancreas after kidney transplants, and 45 to 77% for pancreas transplant alone. Over 80% of pancreas transplant recipients now receive induction therapy. Use of antibody induction has enabled an increase in the use of steroid free maintenance protocols from 4 to 24% of recipients nationwide. Furthermore, a variety of single center protocols, which are both calcineurin inhibitor and corticosteroid free, have recently reported. Finally, there is a growing acceptance of the safety and efficacy of pancreases obtained from donors following cardiac death.

Summary: Pancreas transplantation continues to evolve. To maximize benefits to current and future recipients, creative approaches to improve long-term graft survival and increase the organ supply must be evaluated.

© 2007 Lippincott Williams & Wilkins, Inc.

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