@article{oai:hirosaki.repo.nii.ac.jp:00003772,
 author = {Freise, Chris E.},
 issue = {Supplement},
 journal = {弘前医学},
 month = {Apr},
 note = {The University of California at San Francisco （UCSF）, initiated a pancreas transplant program in 1989. Since that time, nearly 500 procedures have been performed, with the majority being simultaneous pancreas kidney transplants（ SPK）. More recently, pancreas after previous kidney transplant（ PAK）, as well as pancreas transplant alone（ PTA）, have been performed in greater numbers. The procedure has been modified over time, with all cases now having systemic venous drainage, and exocrine drainage into the distal small bowel. Immunosuppression has changed as well, with all patients now receiving thymoglobulin induction, tacrolimus and mycophenolate mofetil maintenance, and prednisone with sirolimus in the PTA and PAK patients, as well as the highly sensitized SPK patients. However, low immunologic risk SPK patients are routinely managed with a steroid free maintenance protocol with excellent short and long term results, as well as rejection rates under 10%. Prophylaxis against immunosuppression related infections has also been an important part of the success, and more recently careful monitoring for polyoma infection has improved outcomes as well. Graft and patient survival for SPK and PTA/PAK continue to be excellent, and this review will discuss the evolution of our program over the last twenty years, reviewing the current approaches that have resulted in this success., 弘前医学. 64(Suppl.), 2013, p.S9-S18},
 pages = {S9--S18},
 title = {Lessons Learned after Twenty Years of Pancreas Transplantation at UCSF},
 volume = {64},
 year = {2013}
}