Pancreas rejection

Weight loss and pancreas histopathology. Diets rejected. 

Unlabeled Uses Prevention of organ rejection in patients receiving allogeneic bone marrow, heart, pancreas, pancreatic island cell, or small-bowel transplant, treatment of autoimmune disease, severe recalcitrant psoriasis... 

The drugs like azathioprine and cyclosporine A are used chiefly to prevent transplant rejection and in the treatment of autoimmune diseases. They are used to prevent graft rejection after kidney, liver, lung, pancreas transplant or bone marrow transplantation. 

Recent data from a kidney pancreas induction study suggests that 2 doses of Daclizumab (2 mg/kg) at day 0 and day 14 is equivalent to 5 doses of 1 mg/kg every 14 days. (Stratta AJ, Alloway RR, Hodge E et al. A multicenter, open-label, comparative trial of two Daclizumab dosing strategies vs. no antibody induction in combination with tacrolimus, mycophenolate mofetil, and steroids for the prevention of acute rejection in simultaneous kidney-pancreas transplant recipients interim analysis. Clin Transplant 2002 l6(l) 60-8.)... 

Prospective, randomized trial did not show a benefit after pancreas transplantation. Octreotide lowers cyclosporine-A levels and may cause escape rejection if cyclosporine levels are not carefully monitored. Intravenous infusions of 25-50 mcg/hour have been utilized. 

Clinical Use. Cyclosporine (Neoral, Sandimmune) is one of the primary medications used to suppress immune function following organ transplantation.14 21 69 This medication can be used alone or combined with glucocorticoids, azathioprine, and other immunosuppressants to prevent the rejection of a kidney, lung, liver, heart, pancreas, and other organ transplants. 

Antithymocyte globulin — Treatment of rejection of kidney, heart, liver, lung, pancreas, and bone marrow transplants... 

A 29-year-old white woman with cadaveric kidney and pancreas transplants had two early rejection episodes but then stabilized on ciclosporin 100 mg bd and prednisolone 5 mg/day. Her blood ciclosporin concentration was consistently 200-350 ng/ml. She then started to take St. John s wort and over the next 30 days her blood ciclosporin concentration fell to 155 ng/ml and 3 weeks later to 97 ng/ml. Her serum creatinine rose to 1.3 mg/dl (115 pmol/l) and... 

A 29-year-old woman, who had received a cadaveric kidney and pancreas transplant, had stable organ function with ciclosporin when she decided to take St. John s wort (25). Subsequently her ciclosporin concentrations became subtherapeutic and she developed signs of organ rejection. St. John s wort was withdrawn and her ciclosporin concentrations returned to the target range. However, she developed chronic kidney rejection and had to return to dialysis. 

The interaction of tacrolimus with fluconazole has been retrospectively evaluated in 19 kidney and pancreas/kid-ney transplant recipients (90). Both intravenous and oral fluconazole altered the blood concentration of tacrolimus. Five subjects did not have a significant interaction and 15 did. No patient had nephrotoxicity or transplant rejection related to antifungal therapy. 

Keown P, Niese D. Cyclosporine microemulsion increases drug exposure and reduces acute rejection without incremental toxicity in de novo renal transplantation. International Sandimmun Neoral Study Group. Kidney Int 1998 54 938-944. Starzl TE, Todo S, Fung J, Demetris AJ, Venkataramman R, Jain A. FK 506 for liver, kidney, and pancreas transplantation. Lancet 1989 2 1000-1004. 

The development of organ transplants—which include kidneys, Mver, heart, lungs, and pancreas— has led to the development of immunosuppressant drugs. These drugs are meant to suppress the body s natural reaction to reject the for-... 

Now that it has been clearly established that Upase hydrolyzes only water-insoluble substrates in a heterogeneous system (6), any method proposing the use of a water-soluble substrate must be rejected. Examples of water-soluble substrates that have been used are the Tweens (189,190) and p-nitrophenyl aeetate and p-nitrophenyl butyrate (191). In fact an entirely different enzyme appears to hydrolyze the Tweens it has been purified from pancreas (192) and been termed a Tweenase (193). An enzyme catalyzing a rapid rate of hydrolysis of Tweens has also been purified from rat adipose tissue (194). 

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