Elevated portal vein drug levels of sirolimus and tacrolimus in islet transplant recipients: local immunosuppression or islet toxicity?1
作者:
Niraj Desai,
John Goss,
Shaoping Deng,
Bryan Wolf,
Eileen Markmann,
Maral Palanjian,
Angela Shock,
Sue Feliciano,
F. Brunicardi,
Clyde Barker,
Ali Naji,
James Markmann,
期刊:
Transplantation
(OVID Available online 2003)
卷期:
Volume 76,
issue 11
页码: 1623-1625
ISSN:0041-1337
年代: 2003
出版商: OVID
数据来源: OVID
摘要:
The recent success of islet transplantation using the Edmonton protocol involved the use of sirolimus, tacrolimus, and daclizumab for immunosuppression. Islets were infused into the portal circulation after transhepatic access. This protocol provided a unique opportunity to measure sirolimus and tacrolimus levels from the portal vein and compare them to systemic venous levels. A total of 11 portal venous samples with a corresponding peripheral venous sample were obtained from patients undergoing a first or second islet infusion and medication levels were obtained on both types of specimens. The portal-to-systemic drug level ratio ranged from 0.95 to 2.71 for sirolimus and 1.0 to 3.12 for tacrolimus. Given the potential toxicity of these agents to islets, the findings in this study may have implications for designing the next generation of immunosuppressive protocols for islet transplantation.
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