Abstract
A variety of experiments have thus far shown cyclosporine to be not nearly as successful in preventing rejection of pancreas allografts (islets, fetal, vascularized segmental) in experimental animals as it is with other tissues. Clinical experience has also been relatively disappointing, although surgeons at most centers have the impression that it is marginally better than azathioprine and steroids. The role of cyclosporine in pancreas transplantation, and indeed the place of pancreas transplantation, remains uncertain at this time.
Résumé
La cyclosporine est un puissant agent immunosuppresseur, de structure cyclique, constitué de 11 acides aminés hydrophobes. C'est dans les hétérogreffes de rein ou de coeur qu'elle a fait la preuve de son efficacité remarquable. Dans les hétérogreffes de pancréas ou d'îlots chez l'animal, la cyclosporine est loin d'atteindre la même efficacité que pour les autres greffes tissulaires. Lors des transplantations de tissu pancréatique chez l'homme, l'association cyclosporine plus corticoïdes donne des résultats voisins de ceux obtenus avec l'association azathioprine plus corticoïdes. L'un des problèmes tient sans doute à la difficulté d'identifier les épisodes de rejet aigu dans les greffes pancréatiques, ce qui rend difficile pour le pancréas le type d'études qui ont été réalisées sur les greffes rénales et cardiaques. La place de la cyclosporine dans la transplantation pancréatique reste à préciser à ce jour.
Resumen
La ciclosporina es un agente inmunosupresor potente que consiste de once aminoácidos hidrofóbicos en una estructura cíclica. La eficacia de este agente inmunosupresor ha sido demostrado en aloinjertos renales y cardiacos en animales. Sin embargo, en investigaciones de aloinjertos de islotes pancreáticos en animales, resultados similares a los demostrados en otros tejidos no han sido confirmados. El uso de la ciclosporina y prednisona en transplante de tejido pancreático ha dado resultados similares a los obtenidos con el uso de la prednisona y azatioprina. La dificultad en la identificación temprana del rechazo agudo hace difícil comparar el uso de este agente en aloinjertos de islotes con los resultados en aloinjertos renales y cardiacos. La utilidad de la ciclosporina en el transplante pancreático no esta todaviá debidamente definida.
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Gray, D.W.R., Morris, P.J. Cyclosporine and pancreas transplantation. World J. Surg. 8, 230–235 (1984). https://doi.org/10.1007/BF01655140
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DOI: https://doi.org/10.1007/BF01655140