Table 2.
Patient groups according to immunosuppression regimens
| Group | Period | Patients (n) | Induction therapy | Maintenance therapy | Years of follow‐up (mean ± SEM) (range) | HG‐T1DR | Years from Tx to HG‐T1DR (mean ± SEM) (range) |
|---|---|---|---|---|---|---|---|
| A | 6/13/1990–5/6/1997 | 16 | OKT3 (n = 16) | CyA (n = 4) or FK (n = 12), AZA (n = 14) or MMF (n = 2), steroids | 9.12 ± 1.20 (2.78–19.07) | 4 | 10.79 ± 2.16 (8.18–17.18) |
| B | 8/2/1997–6/14/2000 | 19 | No induction (n = 11) | FK, MMF, steroids (n = 19) | 7.12 ± 1.11 (4.81–7.93) | 5 | 5.81 ± 0.58a (2.78–19.07) |
| C | Anti‐CD25 (n = 8) | 7.21 ± 1.77 (2.25–14.07) | 1 | 2.25 (na) | |||
| D | 9/6/2000–9/30/2013 | 108 | Thymo + Anti‐CD25 (n = 108) | FK, MMF, steroids (n=55) | 5.51 ± 0.47 (0.94–11.52) | 3 | 7.07 ± 1.52 (4.09–9.08) |
| E | FK, rapamycin, steroids (n=53) | 4.22 ± 0.38 (0.99–10.66) | 2 | 2.38 ± 1.10 (1.28–3.48) | |||
| D+E | FK, MMF, or rapamycin, steroids (n = 108) | 4.88 ± 0.31 (0.94–11.52) | 5 | 5.19 ± 1.46 (1.28–9.08) | |||
| Total | 143 | 15 | |||||
Immunosuppression regimens used at our center, inclusive dates, number of patients in each group, and development of HG‐T1DR. This analysis does not include 80 patients who developed hyperglycemia following rejection or for undetermined cause, and/or who had significant changes in maintenance immunosuppression on follow‐up and would be difficult to assign to a treatment group; the single patient treated with Minnesota anti‐lymphocyte globulin (MALG) was not included. Data are shown for 143 patients: 119 had no changes to maintenance therapy on follow‐up, 24 patients had only early changes (within 6 months) in maintenance drugs and afterwards remained on the same regimens; 128 patients had normal glucose tolerance by the end of follow‐up and 15 patients had developed HG‐T1DR.
Time from transplantation to diagnosis of HG‐T1DR was significantly shorter for Group B when compared to Group A, p = 0.0159; no other comparisons showed statistical differences.
HG‐T1DR, hyperglycemia with type 1 diabetes recurrence; OKT3, anti‐CD3, muromonab; anti‐CD25, daclizumab or basiliximab; CyA, cyclosporine; FK, tacrolimus; AZA, azathiprine; MMF, mycofenilate mofetil.