Abstract:

Thirty years ago when the first immunosuppressive agents became available for clinical grafting, the procedure was regarded with great skepticism by the medical profession as a pastime for ignorant surgeons with results that at best were poor. With the introduction of cyclosporin 15 years ago, the results of organ transplantation improved, and for the first time it was possible to transplant lung and pancreas with a reasonable outcome. Now more than 200,000 organ grafts have been performed worldwide and the procedure is an important established part of therapeutic surgery.

Authors:

Sir Roy Calne, F.R.C.S., F.R.S., Su Metcalfe, B.Sc., M.A., Ph.D., Addenbrooke's Hospital, Cambridge, England

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Abstract:

This chapter will serve to update last year’s report, published in SURGICAL TECHNOLOGY INTERNATIONAL™ III and will discuss our experience at the University of Pittsburgh with the use of tacrolimus as the primary immunosuppressive agent after renal transplantation, and our program of combined kidney–bone marrow transplantation to augment chimerism.

Authors:

Ron Shapiro, M.D., F.A.C.S., University of Pittsburgh School of Medicine, Pittsburgh Transplantation Institute, Pittsburgh, PA

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Abstract:

Kidney transplantation is the most satisfactory modality of treatment for end-stage renal disease. Over the past decade, the results of kidney transplantation have improved dramatically, due to the availability of new immunosuppressive drugs. A newer, more potent drug, Tacrolimus (TAC), approved by the United States Food and Drug Administration on April 12, 1994, is very promising also in renal transplantation, with one-year patient and graft survival equal or superior to results of recipients treated with cyclosporine (CyA). However, the number of patients on dialysis and awaiting kidney transplantation has increased more than fivefold during the past 15 years and now exceeds 26,000.

Authors:

Mario Magnone, M.D., University of Pittsburgh Medical Center, Pittsburgh Transplantation Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA

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