Efficacy and Safety of Tacrolimus Compared With Cyclosporine Microemulsion in Primary Simultaneous Pancreas-Kidney Transplantation: 1-Year Results of a Large Multicenter Trial

Abstract

These findings support the use of tacrolimus therapy for uremic patients with type 1 diabetes who are undergoing SPK transplantation.

Kidney and Pancreas Transplantation for Diabetes: the History of Surgical Techniques and Immunosuppression

“…The results of the first Euro-SPK study were encouraging [58]. The 1-year incidence of biopsyproven acute rejection of the kidney or pancreas was lower with Tac (27.2 %) than with CsAMe (38.2 %; p = 0.09).…”

“…Pancreatic graft survival at 1 year was significantly higher with Tac (91.3 %) than with CsA-Me (74.5 %; p = 0.0014). Kidney graft survival was similar in the two groups [58].…”

“…The overall incidence of adverse events was similar in both groups, but MMF intolerance was more frequent with Tac whereas hyperlipidaemia was more frequent with CsA-Me. Acute rejection was more common among CMV-infected patients (66 vs 41 % without infection; p = 0.001) and in those not receiving ganciclovir prophylaxis [48,58].…”

An Evidence‐Based Analysis of Simultaneous Pancreas‐Kidney and Pancreas Transplantation Alone

“…Except a recommendation A for immunosuppression, the level of evidence for these recommendations and statements is limited to B or C. Despite a few large series with very convincing data (17,24,25,31,32,51), the total number of patients analyzed remains relatively low. We conclude, however, that based on this best available scientific evidence, SPK is currently the gold standard to which other therapies should be compared.…”

“…Excluded were 29 studies with abstract characters only, 20 reviews and five center reports without comparison with different protocols. Of the selected 10 papers, six were ranked level 1b (14,(28)(29)(30)(31)(32) and four level 2b (23,(33)(34)(35).…”