student research day - Case Western Reserve University School of ...
student research day - Case Western Reserve University School of ...
student research day - Case Western Reserve University School of ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Daniel Oberlin<br />
Benefits <strong>of</strong> a Steroid-Free Regimen with Thymoglobulin Induction in Pancreas-Kidney Transplantation<br />
Introduction:<br />
Daniel Oberlin, Emilio Poggio, M.D., Titte Srinivas, M.D., Venkatesh Krishnamurthi, M.D.<br />
Nephrology, Transplantation Center and Glickman Urological Kidney Institute<br />
The Cleveland Clinic Foundation<br />
Steroid-free immunosuppressive protocols in pancreas transplantation are becoming more common due to<br />
improved patient mortality from infectious and cardiovascular disease; yet persistent concerns regarding long-term<br />
graft survival exist. Our clinical observations imply the hypothesis that steroid-free immunosupression protocols<br />
not only <strong>of</strong>fered the same graft-survival as steroid-based protocols but also have provided improved metabolic<br />
outcomes for patient.<br />
Methods:<br />
We performed a retrospective chart review <strong>of</strong> 110 pancreas transplant recipients—77 simultaneous pancreas-<br />
kidney transplants, 50 pancreas-after-kidney transplants, and 19 pancreas transplant alone—who underwent<br />
transplantation within the period <strong>of</strong> January 2002 to August 2007 and who received induction therapy with<br />
thymoglobulin followed by maintenance immunosuppression with tacrolimus and mycophenolate m<strong>of</strong>etil. The chart<br />
review compared one group on a steroid-free regimen with a steroid-based regimen. The two groups were<br />
analyzed for matching baseline characteristics.<br />
Results will portray:<br />
Analysis <strong>of</strong> difference in graft and patient survival between groups.<br />
Analysis <strong>of</strong> acute rejection differences<br />
Difference in hospitalization and infection<br />
Analysis <strong>of</strong> immunologic differences measured by infection with CMV and BK virus.<br />
Comparison <strong>of</strong> body mass index (BMI), lipid pr<strong>of</strong>iles, and blood glucose levels between the two groups.<br />
Conclusion:<br />
Statistical results will determine if a steroid-free regimen <strong>of</strong> thymoglobulin induction followed by tacrolimus and<br />
mycophenolate m<strong>of</strong>etil maintenance provide similar graft-survival and prevention <strong>of</strong> rejection. Furthermore,<br />
because steroid regimens can have significant impact on metabolic parameters which affect patient cardiovascular<br />
risk, results will conclude if steroid-free regimens provide improved clinical outcomes and overall patient health<br />
when compared to steroid-based protocols.<br />
65
Change language