i For comparison, the proportion of recipients of other solid organ transplants receiving induction therapy in 2001 is as follows: kidney ~ 60%; liver ~ 15%; intestine ~ 50%; heart ~ 45%; lung ~ 40%; and heart-lung ~ 75% [from SRTR (X)].

Over the past six years some interesting trends have been observed in the frequency and type of the induction therapy agent used in solitary pancreas (PAK and PTA) and SPK transplant recipients (Fig. 7.11).5 For recipients of SPK transplants in 1996 and 1997, virtually all cases of induction therapy involved the use of either OKT3® or ALG. Beginning in 1998 the use of basiliximab increased from 6.6% to the current rate of 31%,, daclizumab from 13.3% to the current rate of 20.1%, and equine ATG from 0.1% to the current rate of 27.7%. The same trends were observed for recipients of a solitary pancreas transplant from 1996 through 1997 virtually 100% of the cases of induction therapy utilized either OKT3® or ALG (~ 50% of each). Since 1998-9, with the introduction of daclizumab, basiliximab, and equine ATG, the use of these three agents has supplanted those previous two. Among the three new agents, the proportion of solitary pancreas transplant recipients that received equine ATG has increased from 0.4% in 1998 to 55% in 2001.

2. Trends in Maintenance Therapy in Pancreas Transplantation

Maintenance immunosuppressive agents used for pancreas transplantation fall into the following categories: a) corticosteroids, b) calcineurin inhibitors (cyclosporine and tacrolimus), c) antimetabolites (azathioprine and mycophenolate mofetil), and d) other (rapamycin and Cytoxan). In 2001, solitary pancreas recipients received corticosteroids in 93% of cases, tacrolimus in 91% (cyclosporine 8%), mycophenolate mofetil in 74% (azathioprine 1%) and

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