Simultaneous administration of adjuvant donor bone marrow in pancreas transplant recipients. Discussion.
Annual Scientific Session of the American Surgical Association. San Diego, CA, USA, 1999/04.
Objective The effect of donor bone marrow was evaluated for its potentially favorable effect in the authors'simultaneous pancreas/kidney transplant program.
Methods From July 1994 to January 1999,177 pancreas transplants were performed, 151 of which were simultaneous pancreas/kidney transplants.
All patients received tacrolimus, mycophenolate mofetil, and steroids for immunosuppression (azathioprine was used in the first year of the program).
Fifty-three simultaneous pancreas/kidney transplant recipients received perioperative unmodified donor bone marrow, 3 to 6 x 108 cells/kg.
Results Overall actuarial survival rates at 1 and 3 years were 98% and 95% (patient), 95% and 87% (kidney), and 86% and 80% (pancreas), respectively.
In the adjuvant bone marrow group, 1-and 3-year survival rates were 96% and 91% (patient), 95% and 87% (kidney), and 83% and 83% (pancreas), respectively.
For 98 recipients who did not receive bone marrow, survival rates at 1 and 3 years were 100% and 98% (patient), 96% and 86% (kidney), and 87% and 79% (pancreas), respectively.
No pancreas allografts were lost after 3 months in bone marrow recipients, and seven in the non-bone marrow recipients were lost to rejection at 0.7,6.7,8.8,14.6,24.1,24.3, and 25.5 months.
Twenty-two percent of bone marrow patients were steroid-free at 1 year, 45% at 2 years, and 67% at 3 years.
Nineteen percent of the non-bone marrow recipients were steroid-free at 1 year, 38% at 2 years, and 45% (p=0.02) at 3 years. (...)
Mots-clés Pascal : Transplantation, Pancréas, Receveur, Moelle osseuse, Donneur, Traitement adjuvant, Simultané, Evaluation, Efficacité, Etude longitudinale, Homme, Procédure, Chirurgie, Appareil digestif pathologie, Pancréas pathologie
Mots-clés Pascal anglais : Transplantation, Pancreas, Recipient, Bone marrow, Donor, Adjuvant treatment, Concurrent, Evaluation, Efficiency, Follow up study, Human, Procedure, Surgery, Digestive diseases, Pancreatic disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0516571
Code Inist : 002B25G03. Création : 18/05/2000.