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Updated: Jul 3, 2026
Transplantation of Pancreatic Islets Into the Kidney Capsule of Diabetic Mice
Published on: October 31, 2007
Advances in immunosuppression for pancreas transplantation
Rajinder P Singh1, Robert J Stratta
1Department of General Surgery, Section of Transplantation, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
Purpose Of Review:
A review of current literature was performed to identify trends and evaluate outcomes with regard to clinical immunosuppression in pancreas transplantation.
Recent Findings:
Through 2006, over 20 000 pancreas transplantations were performed in the US. Since 2000, the 1-year patient survival rates for the three pancreas transplantation categories--simultaneous pancreas-kidney, sequential pancreas after kidney, and pancreas alone--were 95-97% and the 1-year pancreas graft survival (complete insulin independence) rates were 85%, 78%, and 77%, respectively. One-year rates of rejection have steadily decreased and are currently in the 10-20% range depending on case mix and immunosuppressive regimen. At present, 88% of recipients receive antibody induction, 65% receive maintenance therapy with the tacrolimus/mycophenolate mofetil combination, and 40-50% undergo corticosteroid withdrawal without adverse consequences. Limited data with tacrolimus/sirolimus reveal excellent short-term outcomes, whereas initial attempts with calcineurin inhibitor avoidance or minimization are less promising.
Summary:
Antibody induction and either tacrolimus/mycophenolate mofetil or tacrolimus/sirolimus maintenance therapy with steroid withdrawal have become the mainstay of contemporary immunosuppression in clinical pancreas transplantation. The development of a nonnephrotoxic, nondiabetogenic, and nongastrointestinal toxic regimen, however, is highly desirable to improve outcomes and quality of life in recipients.
