Low incidence of kidney rejection after simultaneous kidney-pancreas transplantation after antithymocyte globulin induction and in the absence of corticosteroids: Results of a prospective pilot study in 28 consecutive cases

Background. Recipients of simultaneous kidney-pancreas transplantation rece ive a combination of polyclonal antithymocyte globulin (ATG), cyclosporin o r tacrolimus, mycophenolate mofetil (MMF) and corticosteroids (Cs). To avoi d the side effects and adverse events associated with Cs, we investigated a new immunosuppressive regimen without Cs after simultaneous kidney-pancrea s transplantation. Methods. A total of 28 consecutive patients who underwent simultaneous kidn ey-pancreas transplantation were included in this study. All patients recei ved ATG, cyclosporin, and MMF. Results. All patients but one tolerated the ATG course well. MMF was defini tively discontinued in three patients because of leukopenia. Cytomegaloviru s infection was diagnosed in eight patients (28.5%). Only two patients (7%) required an antirejection treatment. Patient, kidney, and pancreas surviva l is currently 96.4, 96.4, and 75%, respectively. Conclusions. The combination of ATG, cyclosporin, and MMF, without Cs, was well tolerated. The unexpectedly low (7%) incidence of acute kidney rejecti on observed suggests that Cs may partially interfere with the immunosuppres sive effect of ATG.