Application of combined tacrolimus and mycophenolate mofetil in simultaneous kidney-pancreas transplantation / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the clinical experience of applying the combined tacrolimus (FK506) and mycophenolate mofetil (MMF) in simultaneous pancreas and kidney transplantation (SPKT) with bladder drainage of pancreatic secretion. Methods SPKT was performed for 14 consecutive patients. On the first day after transplantation, triple immunosuppression therapy was appliedwith FK506(0.07-0. 15 mg·kg-1·d-1), MMF(1.0- 1.5 g/d) and prednisone (25 mg/d). The FKS06 blood concentration after oral administration was assayed by the means of MEIA. The occurrence of rejection and the drug toxicity were monitored and recorded. Results Nine recipients survived with the grafts and their general conditions were well. They were followed up for 18--70 months (mean 34 months). There was no early stage complication such as pancreatic fistula and thrombosis after operation. The blood glucose level returned to normal range after operation. All recipients survived over 1 year. Of them, 3 cases survived for 1-3 years,1 case survived for 3-4 years, 1 case survived 4-5 years and 4 cases survived over 5 years. All the cases had normal blood glucose level and early graft function. Removal of allograft pancreas was performed on one patient because of hyperacute rejection. There were 4 cases died. Of whom, one case was diagnosed with duodenal stump leak 45 days after transplantation and he died of corrosive hemorrhage 7 months after operation. One patient died of unexpected heart disease. The 3rd patient died ol multiple organ failure and the fourth case died of acute rejection. Four cases with acute rejection, 2 cases with renal toxicity and 1 case with hepatotoxicity were observed. Conclusions The combination of TAC/MMF has synergetic effect. The application of this combination has good immunosuppression result. It could effectively reduce the risk of acute rejection and improve graft survival in SPKT recipients.