دورية أكاديمية
Multicenter Australian trial of islet transplantation: Improving accessibility and outcomes
| العنوان: | Multicenter Australian trial of islet transplantation: Improving accessibility and outcomes |
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| المؤلفون: | O'Connell, P., Holmes-Walker, D., Goodman, D., Hawthorne, W., Loudovaris, T., Gunton, J., Thomas, H., Grey, S., Drogemuller, C., Ward, G., Torpy, D., Coates, P., Kay, T. |
| المصدر: | http://dx.doi.org/10.1111/ajt.12250Test. |
| بيانات النشر: | Blackwell Munksgaard |
| سنة النشر: | 2013 |
| المجموعة: | The University of Adelaide: Digital Library |
| مصطلحات موضوعية: | Antithymocyte globulin (ATG), diabetes, graft function, hypoglycemia, insulin, insulin independence, islets, sirolimus, tacrolimus, transplantation |
| الوصف: | Whilst initial rates of insulin independence following islet transplantation are encouraging, long-term function using the Edmonton Protocol remains a concern. The aim of this single-arm, multicenter study was to evaluate an immunosuppressive protocol of initial antithymocyte globulin (ATG), tacrolimus and mycophenolate mofetil (MMF) followed by switching to sirolimus and MMF. Islets were cultured for 24 h prior to transplantation. The primary end-point was an HbA1c of <7% and cessation of severe hypoglycemia. Seventeen recipients were followed for ≥ 12 months. Nine islet preparations were transported interstate for transplantation. Similar outcomes were achieved at all three centers. Fourteen of the 17 (82%) recipients achieved the primary end-point. Nine (53%) recipients achieved insulin independence for a median of 26 months (range 7-39 months) and 6 (35%) remain insulin independent. All recipients were C-peptide positive for at least 3 months. All subjects with unstimulated C-peptide >0.2 nmol/L had cessation of severe hypoglycemia. Nine of the 17 recipients tolerated switching from tacrolimus to sirolimus with similar graft outcomes. There was a small but significant reduction in renal function in the first 12 months. The combination of islet culture, ATG, tacrolimus and MMF is a viable alternative for islet transplantation. ; P. J. O'Connell, D. J. Holmes-Walker, D. Goodman, W. J. Hawthorne, T. Loudovaris, J. E. Gunton, H. E. Thomas, S. T. Grey, C. J. Drogemuller, G. M. Ward, D. J. Torpy, P. T. Coates, T. W. Kay, and on behalf of the Australian Islet Transplant Consortium |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1600-6135 1600-6143 |
| العلاقة: | American Journal of Transplantation, 2013; 2013(13):1850-1858; http://hdl.handle.net/2440/87772Test; Grey, S. [0000-0003-2160-1625]; Drogemuller, C. [0000-0001-9770-4845]; Torpy, D. [0000-0002-5069-0981] |
| DOI: | 10.1111/ajt.12250 |
| الإتاحة: | https://doi.org/10.1111/ajt.12250Test http://hdl.handle.net/2440/87772Test |
| حقوق: | © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons |
| رقم الانضمام: | edsbas.AF5F40A5 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 16006135 16006143 |
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| DOI: | 10.1111/ajt.12250 |