Development of new immunosuppression by intra-portal administration of donor specific miss-match antigen in pancreas transplantation

点击翻译按钮获取中文摘要

Donor discharged 2 weeks after surgery without any surgical complication. Recipient's postoperative course was also uneventful. Immunosuppresion was performed by steroid free regimen using thymoglobulin and FK506 and MMF with intraportal infusion of donor specific antigens^2. There were neither hemorrhage nor pancreatic leakage. She discharged 15 days after transplantation. Immunological analysis revealed of activation of interleukin 10 of Th2 type cytokine on day 7 after transplantation(Fig1). Mixed lymphocyte reaction demonstrated the donor specific immunosuppression at 8 month after transplantation. She released from hypoglycemia. Her body weight decreased by 56kg and HbA1c decreased to 5.1% for 6 months after the operation. There are no any rejection until now.The first case of both physiologic enteric drainage and steroid free regiment were successfully performed in LRPT in Japan. Enteric drainage has remarkably increased in cadaver pancreas transplantation. In living partial pancreas transplantation, the enteric drainage is considered to be one option as physiologic reconstruction under careful surgical technique. LRPT might be very useful therapy for type I diabetes mellitus for preventing diabetic complication with cadaver pancreas transplantation. We have already reported about the intraportal administration of donor specific transfusion in living related liver transplantation. In this study, it was demonstrated that the intraportal administration of donor leukocytes might be also effective as induction therapy for steroid free regiment in LRPT such as our experienced of living related liver transplantation.