Abstract
Between November 1995 and July 1997, we performed 20 consecutive SPK. The mean (6SD) age of the recipients was 35 6 5 yrs; 14 were male and 6 were female. All patients were dialysisdependent before transplantation, with a mean duration of dialysis of 23 6 15 months. The donor/recipient HLA mismatch was 5.1 6 0.8. All patients received a whole-organ pancreas graft with bladder drainage. Immunosuppression consisted of sequential antilymphocyte serum for 10 days, adjusted to maintain the absolute lymphocyte count #0.2 3 10/L; prednisone (tapered to 20 mg/d by day 5, 10 mg/d by 3 months, and 5 mg/d by 1 year); azathioprine (2mg/kg/d); and Neoral beginning on day 5. Intravenous cyclosporine was not used. Neoral dosage was adjusted to maintain whole blood trough values of 350 to 400 mg/L, by RIA during the first month, 300 to 350 mg/L until month 3, and 250 to 350 mg/L thereafter. All rejection episodes were suspected by a rise in serum creatinine .20% above baseline and were all biopsy proven. Antiviral prophylaxis consisted of intravenous ganciclovir for 3 months. All patients have been followed for a minimum of 4 months.
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