Management of hyperglycaemia after pancreas transplantation: Are new immunosuppressants the answer?

Drugs

Volumn 65, Issue 2, 2005, Pages 153-166

  Egidi, Francesca M ^a  

^a UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALEMTUZUMAB; BASILIXIMAB; CALCINEURIN INHIBITOR; CORTICOSTEROID; CYCLOSPORIN A; DACLIZUMAB; FINGOLIMOD; GLUCOSE; GLYCOSYLATED HEMOGLOBIN; INSULIN; LEFLUNOMIDE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; OKT 3; RAPAMYCIN; TACROLIMUS; THYMOCYTE ANTIBODY;

ACUTE GRAFT REJECTION; ACUTE PANCREATITIS; ANASTOMOSIS; AUTOIMMUNITY; CELL DESTRUCTION; CLINICAL PROTOCOL; CONCENTRATION RESPONSE; DIABETES CONTROL; DIABETES MELLITUS; DIABETOGENESIS; DONOR SELECTION; DRUG DOSE REGIMEN; DRUG EFFICACY; DRUG SAFETY; DRUG WITHDRAWAL; GLUCOSE BLOOD LEVEL; GLUCOSE INTOLERANCE; GLUCOSE METABOLISM; GRAFT DYSFUNCTION; GRAFT FAILURE; GRAFT REJECTION; GRAFT SURVIVAL; HORMONE RELEASE; HUMAN; HYPERGLYCEMIA; HYPERINSULINEMIA; IMMUNOSUPPRESSIVE TREATMENT; IMPAIRED GLUCOSE TOLERANCE; IMPAIRED INSULIN SECRETION; INFLAMMATION; INSULIN CLEARANCE; INSULIN RELEASE; INSULIN RESISTANCE; KIDNEY FAILURE; LONG TERM CARE; LOW DRUG DOSE; MAINTENANCE THERAPY; METABOLIC DISORDER; NEPHROTOXICITY; ORGAN DONOR; OUTCOMES RESEARCH; PANCREAS FUNCTION; PANCREAS INSUFFICIENCY; PANCREAS ISLET CELL; PANCREAS TRANSPLANTATION; PORTAL DRAINAGE; POSTOPERATIVE COMPLICATION; RECURRENT DISEASE; REVIEW; STOMACH PARESIS; SURGICAL DRAINAGE; SURGICAL TECHNIQUE; TREATMENT INDICATION; TREATMENT WITHDRAWAL;

ANIMALS; ANTI-INFLAMMATORY AGENTS; AUTOIMMUNITY; GRAFT REJECTION; HUMANS; HYPERGLYCEMIA; HYPERINSULINISM; IMMUNOSUPPRESSIVE AGENTS; PANCREAS TRANSPLANTATION; POSTOPERATIVE COMPLICATIONS;

EID: 12344284709     PISSN: 00126667     EISSN: None     Source Type: Journal    
DOI: 10.2165/00003495-200565020-00001     Document Type: Review

References (117)

1. American Diabetes Association. Clinical practice recommendations. Diabetes Care 1999; 22: S1-114
2. Gerik JE. Type 2 diabetes mellitus as a heterogeneous disorder: implications for treatment. Mayo Clin Proc 2003; 78 (4): 447-56
3. Goran MI, Ball GDC, Cruz ML. Obesity and risk for type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab 2003; 88 (4): 1417-27
4. Dandona P, Aljada A, Chaudhuri A, et al. The potential influence of inflammation and insulin resistance on the pathogenesis and treatment of atherosclerosis-related complications in type 2 diabetes. J Clin Endocrinol Metab 2003; 88 (6): 2422-9
5. Hakim N, Stratta RJ, Gray D, editors. Pancreas and islets transplantation. New York: Oxford University Press Inc., 2002
6. Light JA, Sasaki TM, Currier CB, et al. Successful long-term kidney-pancreas transplants regardless of C-peptide status or race. Transplantation 2001; 71: 152-4
7. Pox C, Ritzel R, Büsing M, et al. Combined pancreas and kidney transplantation in a lean type 2 diabetic patients: effect on insulin secretion and sensitivity. Exp Clin Endocrinol Diabetes 2002; 110: 420-4
8. Ketel B, Henry ML, Elkhammas EA, et al. Metabolic complications in combined kidney/pancreas transplantation. Transplant Proc 1992; 24: 774-5
9. Pfeffer F, Naucj MA, Benz S, et al. Determinants of a normal (versus impaired) oral glucose tolerance after combined pancreas-kidney transplantation in IDDM patients. Diabetologia 1996; 39: 462-8
10. Battezzati A, Benedini S, Caldara R, et al. Prediction of the long-term metabolic success of the pancreatic graft function. Transplantation 2001; 71: 1560-6
11. Marchetti P. New-onset diabetes after transplantation. J Heart Lung Transplant 2004; 23 (5 Suppl): S194-201
12. Weir MR, Fink JC. Risk of posttransplant diabetes mellitus with current immunosuppressive medications. Am J Kidney Dis 1999; 34: 1-13
13. Cosio FG, Pesavento TE, Osei K, et al. Post-transplant diabetes mellitus: increasing incidence in renal allograft recipients transplanted in recent years. Kidney Int 2001; 59: 732-7
14. Budde K, Schmouder RL, Brunkhorst R, et al. First human trial of FTY720, a novel immunomodulator, in stable renal transplant patients. J Am Soc Nephrol 2002; 13: 1073-83
15. Strand V, Cohen S, Schiff M, et al. Treatment of active rheumatoid arthritis with leflunomide compared with placebo and methotrexate: Leflunomide Rheumatoid Arthritis Investigators Group. Arch Intern Med 1999; 159: 1121-8
16. Hardinger KL, Wang CD, Schnitzler MA, et al. Prospective, pilot, open-label, short-term study of conversion to leflunomide reverses chronic renal allograft dysfunction. Am J Transplant 2002; 29: 867-71
17. Kahan BD, Karlix JL, Ferguson RM, et al. Pharmacodynamics, pharmacokinetics, and safety of multiple doses of FTY720 in stable renal transplant patients: a multicenter, randomized, placebo-controlled, phase I study. Transplantation 2003; 76: 1079-84
18. Jindal RM. Posttransplant diabetes mellitus: a review. Transplantation 1994; 58: 1289-98
19. Gaston RS, Chandrakantan A. Diabetes mellitus after kidney transplantation. Am J Transplant 2003; 3: 512-3
20. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003; 26 Suppl. 1: S5-S20
21. First R, Gerber D, Hariharan S, et al. Posttransplant diabetes mellitus in kidney allograft recipients: incidence, risk factors and management. Transplantation 2002; 73: 379-86
22. Caronia S, Taylor K, Pagliaro L. Further evidence for an association between non insulin dependent diabetes mellitus and chronic hepatitis C virus infection. Hepatology 1999; 30: 1059-63
23. Yildiz A, Tutuncu Y, Yazici H, et al. Association between hepatitis C virus infection and development of post transplant diabetes in renal transplant patients on tacrolimus. Transplantation 2002; 74: 1109-13
24. Bloom RD, Rao V, Weng F, et al. Association of hepatitis C with post transplant diabetes in renal transplant recipients on tacrolimus. J Am Soc Nephrol 2002; 13: 1374-80
25. Honaker MR, Stratta RJ, Lo A, et al. Impact of hepatitis C virus status in pancreas transplantation: a case control study. Clin Transplant 2002; 16: 243-51
26. Heisel O, Heisel R, Balshaw R, et al. New onset diabetes mellitus in patients receiving calcineurin inhibitors: A systematic review and meta-analysis. Am J Transplant 2004; 4: 583-95
27. Davinson J, Wilkinson A, Dantal J, et al. New-onset diabetes after transplantation: 2003 international consensus guidelines. Transplantation 2003; 75: SS3-24
28. Egidi MF, Stratta RJ, Trofe J, et al. Is the native pancreas more susceptible to abnormalities causing glucose intolerance than the pancreas transplant [abstract]? 7th World Congress of International Pancreas and Islet Transplant Association; 1999 Aug 22-25; Sydney, 102
29. Humar A, Johnson E, Gillingham KJ, et al. Venous thromboembolic complications after kidney and kidney-pancreas transplantation: a multivariate analysis. Transplantation 1998; 65: 229-34
30. Kapur S, Bonham CA, Dodson FS, et al. Strategies to expand the donor pool for pancreas transplantation. Transplantation 1999; 67 (2): 284-90
31. Benedetti E, Sileri P, Grussner AC, et al. Surgical complications of pancreas transplantation. In: Hakim N, Stratta RJ, Gray D, editors. Pancreas and islet transplantation. New York: Oxford University Press Inc., 2002: 155-65
32. Frezza EE, Corry RJ. Donor management and selection for pancreas transplantation. In: Hakim N, Stratta RJ, Gray D, editors. Pancreas and islet transplantation. New York: Oxford University Press Inc., 2002: 79-87
33. Humar A, Kandaswamy R, Drangstveit B, et al. Prolonged preservation increases surgical complications after pancreas transplants. Surgery 2000; 127: 545-51
34. Tamsma JT, Schaapherder AFM, van Bronswijk H, et al. Islet cell hormone release immediately after human pancreatic transplantation. Transplantation 1993; 56: 1119-23
35. Troppmann C, Gruessner A, Papalois BE, et al. Delayed endocrine pancreas graft function after simultaneous pancreas-kidney transplantation. Transplantation 1996; 61: 1323-30
36. Tan M, Kandaswamy R, Sutherland DER, et al. Risks factors and impact of delayed graft function after pancreas transplants. Am J Transplant 2004; 4: 758-62
37. Zimmerman T, Horber F, Rodriguez N, et al. Contribution of insulin resistance to catabolic effects of prednisone on leucine metabolism in humans. Diabetes 1989; 38: 1238-44
38. Miyazaki Y, He H, Mandarino LJ, et al. Rosiglitazone improves downstream insulin receptor signaling in type 2 diabetic patients. Diabetes 2003; 52: 1943-50
39. Douzdjian V, Cooper JL, Abecassis MM, et al. Markers for pancreatic allograft rejection: comparison of serum anodal tripsinogen, serum amylase, serum creatinine and urinary amylase. Clin Transplant 1994; 8: 79-82
40. Sugitani A, Egidi MF, Gritsch HA, et al. Serum lipase as a marker for pancreatic rejection. Clin Transplant 1998; 12: 175-83
41. Shapiro R, Jordan ML, Scantlebury VP, et al. Renal allograft rejection with normal renal function in simultaneous kidney/ pancreas recipients: does dissynchronous rejection really exists? Transplantation 2000; 69 (3): 440-1
42. Papadimitriou JC, Drachenberg CB. Role of histopathology in pancreas transplantation. Curr Opin Organ Transplant 2002; 7: 185-90
43. Gaber LW, Egidi MF. Surveillance and monitoring of pancreas allografts. Curr Opin Organ Transplant 2002; 7: 191-5
44. Egidi MF, Shapiro R, Khanna A, et al. Fine-needle aspiration biopsy in pancreatic transplantation. Transplant Proc 1995; 27: 3055-6
45. Esmajies E, Rodriguez-Villar C, Richart MJ, et al. Recurrence of immunological markers for type 1 (insulin-dependent) diabetes mellitus in immunosuppressed patients after pancreas transplantation. Transplantation 1998; 66: 128-31
46. Braghi S, Bonifacio E, Secchi A, et al. Modulation of humoral islet autoimmunity by pancreas allotransplantation influences allograft outcome in patients with type 1 diabetes. Diabetes 2000; 49: 218-24
47. Yoon JW, Yoon CS, Lim HW, et al. Control of autoimmune diabetes in NOD mice by GAD expression or suppression in cells. Science 1999; 284: 1183-7
48. Burke G, Ciancio G, Miller J, et al. Hyperglycemia occurring 5-8 years after simultaneous pancreas-kidney (SPK) transplantation associated with the prior development of islet cell antibodies [abstract no. 889]. Am J Transplant 2003; 3 Suppl. 5: 380
49. Dupre J, Stiller CR, Gent M, et al. Clinical trials of cyclosporin in IDDM. Diabetes Care 1988; 11 Suppl. 1: 37-44
50. Murase N, Lieberman I, Nalesnik MA, et al. Effects of FK506 on spontaneous diabetes in BB rats. Diabetes 1990; 39: 1584-6
51. Martel RR, Klicious J, Galet S. Inhibition of the immune response by rapamycin, a new antifungal antibiotic. Can J Physiol Pharmacol 1977; 55: 48-51
52. Luzi L, Secchi A, Facchini F, et al. Reduction of insulin resistance by combined kidney-pancreas transplantation in type 1 (insulin-dependent) diabetic patients. Acta Diabetologica 1990; 33: 549-56
53. Diem P, Abid M, Redmon JB, et al. Systemic venous drainage of pancreas allografts as independent cause of hyperinsulinemia in type 1 diabetic recipients. Diabetes 1990; 39: 534-40
54. Widerman L, Elahi D, Hanks J. Whole organ transplantation and glucose regulation. World J Surg 2001; 25: 516-22
55. Gaber AO, Shokouh-Amiri H, Hathaway DK, et al. Results of pancreas transplantation with portal venous and enteric drainage. Ann Surg 1995; 221: 613-24
56. Tajra LC, Martin X, Benchaid M, et al. Long-term metabolic control in pancreas transplant patients according to three techniques. Transplant Proc 1998; 30: 268-9
57. Shokouh-Amiri MH, Rahimi-Saber S, Andersen AJ. Segmental pancreatic autotransplantation in the pig. Transplantation 1989; 47: 42-4
58. Philosophe B. Portal versus systemic delivery of insulin: immunologic benefits for pancreas transplantation. Curr Opin Organ Transplant 2002; 7: 180-4
59. Nymann T, Hathaway DK, Shokouh-Amiri MH, et al. Patterns of acute rejection in portal-enteric versus systemic-bladder pancreas-kidney transplantation. Clin Transplant 1998; 12:15-83
60. Christiansen E, Vestergaard H, Tibell A, et al. Impaired insulin-stimulated nonoxidative glucose metabolism in pancreas-kidney transplant recipients. Diabetes 1996; 45: 1267-75
61. Luzi L, Battezzati A, Perseghin GL, et al. Lack of feedback inhibition of insulin secretion in denervated human pancreas. Diabetes 1992; 41: 1632-9
62. Berry SM, Friend LA, McFadden DW, et al. Pancreatic denervation does not influence glucose-induced insulin response. Surgery 1994; 116: 67-75
63. Bewick M, Mundy AR, Eaton B, et al. Endocrine function of the heterotopic pancreatic allotransplantation in dogs. III: the causes of hyperinsulinemia. Transplantation 1981; 31: 23-5
64. Borch-Johnsen K, Colangiuri S, Balkau B, et al. Creating a pandemic of prediabetes: the proposed new diagnostic criteria for impaired fasting glycemia. Diabetologia 2004; 47: 1396-402
65. Arner P, Gunnarsson R, Blomdahl G, et al. Some characteristics of steroid diabetes: a study in renal transplant recipients receiving high dose corticosteroid therapy. Diabetes Care 1983; 6: 23-5
66. Gunnarsson R, Lundgren G, Magnusson G, et al. Steroid diabetes: a sign of overtreatment with steroids in the renal graft recipients? Scand J Urol Nephrol Suppl 1980; 54: 135-8
67. Hricik DE, Bartucci MR, Moir EJ, et al. Effects of steroid withdrawal on posttransplant diabetes mellitus in cyclosporine-treated renal transplant recipients. Transplantation 1991; 51: 374-7
68. Schulak JA, Mayes JT, Moritz CE, et al. A prospective randomized trial of prednisone versus no predinisone maintenance therapy in cyclosporine-treated and azathioprine-treated renal transplant patients. Transplantation 1990; 49: 327-32
69. Ahsan N, Hricik D, Matas A, et al. Prednisone withdrawal in kidney transplant recipients on cyclosporine and mycophenolate mofetil: a prospective randomized study. Transplantation 1999; 68: 1865-74
70. Jordan ML, Chakrabarti P, Luke P, et al. Results of pancreas transplantation after steroid withdrawal under tacrolimus immunosuppression. Transplantation 2000; 69: 265-71
71. MacDonald A. Improving tolerability of immunosuppressive regimens. Transplantation 2001; 72 (12 Suppl.): S105-12
72. Kaufman DB, Leventhal JR, Koffron AJ, et al. A prospective study of rapid corticosteroid elimination in simultaneous pancreas-kidney transplantation: comparison of two maintenance immunosuppression protocols: tacrolimus/ mycophenolate mofetil versus tacrolimus/sirolimus. Transplantation 2002; 73: 169-77
73. Cantarovich D, Giral-Classe M, Hourmant M, et al. Low incidence of kidney rejection after simultaneous kidney-pancreas transplantation after antithymocyte globulin induction and in absence of corticosteroids: results of a prospective pilot study in 28 consecutive cases. Transplantation 2000; 69: 1505-8
74. Almawi WY, Lipman ML, Stevens AC, et al. Abrogation of glucocorticoid mediated inhibition of T-cell proliferation by the synergistic action of IL-1, IL-6 and IFN-gamma. J Immunol 1991; 146: 3523-7
75. Shapiro AMJ, Lakey JRT, Ryan EA, et al. Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med 2000; 343: 230-8
76. Kenyon NS. Experimental approaches to the prevention of islet rejection. In: Hakim N, Stratta RJ, Gray D, editors. Pancreas and islet transplantation. New York: Oxford University Press Inc., 2002: 339-53
77. Ericzon BG, Wijnen RMH, Tiebosh A, et al. The effects of FK506 treatment on pancreaticoduodenal allotransplantation in the primate. Transplantation 1992; 53: 1184-9
78. Kasiske BL, Snyder JJ, Gilbertson D, et al. Diabetes mellitus after kidney transplantation in the United States. Am J Transplant; 2003; 3: 178-85
79. Cosio FG, Pesavento TE, Kim S, et al. Patient survival after renal transplantation. IV: impact of post-transplant diabetes. Kidney Int 2002; 62: 1440-6
80. Krausz Y, Wollheim CB, Siegel E, et al. Possible role for calmodulin in insulin release: studies with trifluperazine in the rat pancreatic islets. J Clin Invest 1980; 66: 603-7
81. Harding MW, Galat A, Uehling DE, et al. A receptor for the immunosuppressant FK506 is a cis-transpeptidyl-propyl isomerase. Nature 1989; 341: 758-60
82. Pirsch J, Miller J, Deierhoi M, et al. A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation: FK506 Kidney Transplant Study Group. Transplantation 1997; 63: 977-83
83. Woo M, Przepiorka D, Ippoliti C, et al. Toxicities of tacrolimus and cyclosporin A after allogenic blood stem cell transplantation. Bone Marrow Transplant 1997; 20: 1095-8
84. Drachenberg CB, Klassen DK, Weir MR, et al. Islet cell damage associated with tacrolimus and cyclosporine: morphological features in pancreas allograft biopsies and clinical correlation. Transplantation 1999; 68: 396-402
85. Vincenti F, Jensik SK, Filo RS, et al. A long-term comparison of tacrolimus (FK506) and cyclosporine in kidney transplantation: evidence for improved allograft survival at five years. Transplantation 2002; 73: 775-82
86. Elmer DS, Abdulkarim AB, Fraga D, et al. Metabolic effects of FK506 (tacrolimus) versus cyclosporine in portally drained pancreas allografts. Transpl Proc 1998; 30: 523-4
87. Dieterle C, Schmauss S, Veitenhasl M, et al. Glucose metabolism after pancreas transplantation: cyclosporine versus tacrolimus. Transplantation 2004; 77: 1561-5
88. Egidi MF, Trofe J, Stratta RJ, et al. Glucose control in pancreas transplants: comparative study among anastomotic techniques [abstract]. 7th World Congress of International Pancreas and Islet Transplant Association; 1999 Aug 22-25; Sydney, 72
89. Vincenti F, Ramos E, Brattstrom C, et al. Multicenter trial exploring calcineurin inhibitors avoidance in renal transplantation. Transplantation 2001; 71: 1282-7
90. Kreis H, Oberbauer R, Campistol J, et al. Long-term benefits with sirolimus-based therapy after early cyclosporin withdrawal. J Am Soc Nephrol 2004; 15: 809-17
91. Stratta RJ, Alloway RR, Lo A, et al. Two-dose daclizumab regimen in simultaneous kidney-pancreas transplant recipients: primary endpoint analysis of a multicenter, randomized study. Transplantation 2003; 75: 1260-6
92. Gruessner AC, Sutherland DER. Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of October 2002. Clin Transpl 2002, 41-77
93. Kaufman DB, Iii GW, Brace DS, et al. Prospective, randomized, multi-center trial of antibody induction therapy in simultaneous pancreas-kidney transplantation. Am J Transplant 2003; 3: 855-64
94. Kirk AD, Hale DA, Mannon RB, et al. Results from a human renal allograft tolerance trial evaluating the humanized CD52-specific monoclonal antibody Alemtuzumab (Campath-1H). Transplantation 2003; 76: 120-9
95. Knechtle SJ, Pirsch JD, Flechner Jr J, et al. Campath-1H induction plus rapamycin monotherapy for renal transplantation: results of a pilot study. Am J Transplant 2003; 3: 722-30
96. Sutherland DER. Immunosuppression for Beta-cell replacement to restore or enhance endogenous insulin secretion by transplantation in diabetic recipients [abstract]. Transplant Immunosuppression 2003: the Continuing Challenges; 2003 Oct 1-4; Minneapolis, 234-44
97. Stratta RJ. Review of immunosuppressive usage in pancreas transplantation. Clin Transplant 1999; 13: 1-12
98. Halloran P, Mathew T, Tomlanovich S, et al. Mycophenolate mofetil in renal allograft recipients: a pooled efficacy analysis of three randomized, double-blind, clinical studies in prevention of rejection: the International Mycophenolate Mofetil Renal Transplant Study Groups. Transplantation 1997; 63: 39-47
99. Williams JW, Mital D, Chong A, et al. Experience with leflunomide in solid organ transplantation. Transplantation 2002; 73: 358-66
100. Wennberg L, Karlsson-Parra A, Sunderberg B, et al. Efficacy of immunosuppressive drugs in islet xenotransplantation: leflunomide in combination with cyclosporine and mycophenolate mofetil prevents islet xenograft rejection in pig-to-rat model. Transplantation 1997; 63: 1234-42
101. Guo Z, Chong AS, Shen J, et al. Prolongation of rat islet allograft survival by the immunosuppressive agent leflunomide. Transplantation 1997; 63: 711-6
102. Stepkowski SM, Wang M, Qu X, et al. Synergistic interaction of FTY720 with cyclosporine or sirolimus to prolong heart allograft survival. Transpl Proc 1998; 30: 2214-6
103. Kahan BD, Kaplan B, Lorber M, et al. RAD in the novo renal transplantation: comparison of three doses on the incidence and severity of acute rejection. Transplantation 2001; 71: 1400-6
104. MacDonald AS. A worldwide, phase III, randomized, controlled, safety and efficacy study of a sirolimus/cyclosporine regimen for prevention of acute rejection in recipients of primary mismatched renal allografts. Transplantation 2001; 71: 271-80
105. Flechner SM, Goldfarb D, Modlin C, et al. Kidney transplantation without calcineurin inhibitor drugs: a prospective, randomized trial of sirolimus versus cyclosporine. Transplantation 2002; 74: 1070-6
106. Sehgal SN. Sirolimus: its discovery, biological properties, and mechanism of action. Transpl Proc 2003; 35 (3 Suppl.): 7S-14S
107. Takano A, Usui I, Haruta T, et al. Mammalian target of rapamycin pathway regulates insulin signaling via subcellular redistribution of insulin receptor substrate 1 and integrates nutritional signals and metabolic signals of insulin. Mol Cell Biol 2001; 21: 5050-62
108. Haruta T, Uno T, Kawahara J, et al. A rapamycin-sensitive pathway down-regulate insulin signaling via phosphorylation and proteosomal degradation of insulin receptor substrate-1. Mol Endocrinol 2000; 14: 783-94
109. Hong JC, Kahan BD. Sirolimus-induced thrombocytopenia and leukopenia in renal transplant recipients: risk factors, incidence, progression and management. Transplantation 2000; 69: 2085-90
110. Hoogeveen RC, Ballantyne CM, Pownall HJ, et al. Effects of sirolimus on the metabolisms of apoB100-containing lipoproteins in renal transplant patients. Transplantation 2001; 72: 1244-50
111. Chueh SC, Kahan BD. Dyslipidemia in renal transplant recipients treated with a sirolimus and cyclosporine-based immunosuppressive regimen: incidence, risk factors, progression, and prognosis. Transplantation 2003; 76: 375-82
112. Salazar A, McAlister VC, Kiberd VA, et al. Sirolimus-tacrolimus combination for combined kidney-pancreas transplantation; effect on renal function. Transplant Proc 2001; 33: 1038-9
113. Freise CE, Kang SM, Feng S, et al. Excellent short-term results with steroid-free maintenance immunosuppression in low-risk simultaneous pancreas-kidney transplantation. Arch Surg 2003; 138: 1121-6
114. MacDonald AS. Rapamycin in combination with cyclosporine or tacrolimus in liver, pancreas, and kidney transplantation. Transplant Proc 2003; 35 (3 Suppl.): 183S-6S
115. Vincenti F, Stock P. De novo use of sirolimus in immunosuppression regimens in kidney and kidney-pancreas transplantation at the university of California, San Francisco. Transplant Proc 2003; 35 (3 Suppl.): 183S-6S
116. Egidi MF, Cowan PA, Naseer A, et al. Conversion to sirolimus in solid organ transplantation: a single center experience. Transplant Proc 2003; 35 (3 Suppl.): 131S-7S
117. Lo A, Egidi MF, Gaber LW, et al. Observations regarding the use of sirolimus and tacrolimus in high-risk renal transplant recipients. Clin Transplant 2004; 18: 53-61