Cyclosporine challenge test revisited: Does it predict outcome after solitary pancreas transplantation?

James T. Lane, Tanaporn Ratanasuwan, Lynn R. Mack-Shipman, Rodney J. Taylor, John P. Leone, Suzanne A. Miller, Elizabeth R. Lyden, Jennifer L. Larsen

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: The selection of patients for solitary pancreas transplantation (PTA) requires identification of individuals who will not develop acute renal dysfunction in response to immunosuppressants. A cyclosporine challenge test (CCT) was developed to predict post-PTA kidney dysfunction secondary to calcineurin inhibitor immunosuppressants. We now report on the long-term follow-up of patients who received a PTA after undergoing a CCT. Methods: Twelve potential PTA recipients were administered cyclosporine A (CsA) for 6 wk. Creatinine clearance (CrCl) was measured at 2, 4, and 6 wk. Those who did not fail the CCT received PTA. Baseline and post-transplant CrCl were retrospectively evaluated in the original cohort and in a group of matched patients who received PTA without a CCT. Results: Of the original 12 recipients evaluated with the CCT, 6 received PTA. CrCl was followed for a mean of 45.8 months. Of the 4 who remained alive, 2 went on to develop renal failure (CrCl <30 mL/min) at 18 and 65 months post-transplant. The baseline CrCI was higher in PTA recipients who had not been selected to be studied with CCT than those that were (117 ± 32 vs 78 ± 13 mL/min). By 12 months post-PTA, the CrCl was no longer different between the groups selected to be screened with CCT and those that were not. Conclusions: CCT may help predict risk for short-term changes in renal function (< 18 months) in response to CsA. CCT may be most helpful in candidates for PTA with borderline renal insufficiency (60-80 mL/min).

Original languageEnglish (US)
Pages (from-to)28-31
Number of pages4
JournalClinical Transplantation
Volume15
Issue number1
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Immunosuppressants
  • Kidney
  • Pancreas transplantation
  • Tacrolimus
  • Type 1 diabetes

ASJC Scopus subject areas

  • Transplantation

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