【Background】Induction therapy in simultaneous pancreas-kidney transplant (SPK) recipients has been a common practice because a consequence of acute rejection (AR) in SPK could result in a serious situation. Although a single IL-2 receptor antibody induction had been popular here in Japan for years, AR incidence rate was still high. We recently adopted a dual induction with anti-thymocyte globulin (ATG) and basiliximab (BXM) in SPK and now report its clinical results.

【Method】We conducted 19 SPK between 2010 and 2014. A single induction therapy (SIT) with BXM was applied in 12 cases until 2012. After 2013, a dual induction therapy (DIT) with ATG and BXM was used. We compared their clinical consequences.

【Results】Average donor/recipient ages of SIT group vs. DIT group were 40.4±15.8 vs. 37.3±6.5/ 45.2±4.8 vs. 45.4±9.9, respectively. The regimen in SIT consisted of tacrolimus, MMF and steroid with BXM. That in DIT was composed of tacrolimus ER, MMF and steroid with ATG and BXM and everolimus was added later. 1-year graft survival rates of DIT vs. SIT were 7/7 (100%) vs. 11/12(91.7%), respectively. 12-month AR free ratios of DIT vs. SIT were 100% vs. 83.3% (p=0.269), respectively. No AR was found in DIT group for 17 months at longest after surgery. Significant white blood count or platelet count decline was not detected in DIT group compared to SIT. There was also no significant difference in PCP, CMV or urinary tract infection (UTI) incidence between two groups.

【Conclusion】SPK recipients who received DIT with ATG and BXM showed no AR and no graft loss for 17 months at most after transplant. Although there was no significant statistical difference of AR incidence between DIT and SIT probably due to lack of statistical power, DIT has safely reduced incidence of AR in SPK with no apparent adverse event increaed.

« Back to 2015 American Transplant Congress