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Regulatory T cells: Therapeutic Potential for Treating Transplant Rejection and Type I Diabetes
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How Should Pancreas Transplant Rejection Be Treated?
Fahad Aziz1, Sandesh Parajuli1, Salah Uddin1
1Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Transplantation
|June 25, 2019
Summary
For pancreas transplant rejection, grade I can be treated with steroids alone. However, grades II and III benefit from steroids plus antithymocyte globulin (ATG), improving response and graft survival.
Area of Science:
- Transplant Surgery
- Immunosuppression Therapy
- Nephrology
Background:
- Limited data guide pancreas transplant rejection treatment.
- Pancreas transplantation is a vital treatment for end-stage renal disease.
Purpose of the Study:
- To compare treatment outcomes for pancreas transplant rejection.
- To evaluate steroid monotherapy versus combination therapy with antithymocyte globulin (ATG).
Main Methods:
- Retrospective review of 158 first episodes of biopsy-proven pancreas rejection.
- Comparison of treatment response and graft survival based on Banff rejection grade.
- Analysis of steroids alone vs. steroids plus ATG.
Main Results:
- Steroids alone showed response rates of 83% (grade I), 60% (grade II), and 33.3% (grade III).
- Steroids plus ATG yielded response rates of 69% (grade I), 76% (grade II), and 73% (grade III).
- ATG addition significantly improved response and graft survival for grades II and III rejection.
Conclusions:
- Grade I pancreas rejection is effectively treated with steroids alone.
- Grades II and III pancreas rejection necessitate steroids plus ATG for improved outcomes.
- ATG is crucial for enhancing response rates and graft survival in moderate to severe rejection.
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