Elevated portal vein drug levels of sirolimus and tacrolimus in islet transplant recipients: Local immunosuppression or islet toxicity

Niraj M. Desai, John A. Goss, Shaoping Deng, Bryan A. Wolf, Eileen Markmann, Maral Palanjian, Angela P. Shock, Sue Feliciano, F. Charles Brunicardi, Clyde F. Barker, Ali Naji, James F. Markmann

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1623-1625
Number of pages3
JournalTransplantation
Volume76
Issue number11
DOIs
StatePublished - Dec 15 2003
Externally publishedYes

ASJC Scopus subject areas

  • Transplantation

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