Steroid Avoidance in Two-Haplotype-Matched Living Donor Renal Transplants with Basiliximab Induction Therapy

• Published in: Transplantation proceedings Vol. 42; no. 10; pp. 4526 - 4529
• Main Authors: Afaneh, C, Halpern, J, Cheng, E, Aull, M, Figueiro, J, Kapur, S, Leeser, D.B
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.12.2010; Elsevier
• Subjects: Adult; Antibodies, Monoclonal - administration & dosage; Biological and medical sciences; BK Virus - isolation & purification; Cytomegalovirus - isolation & purification; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Survival; Haplotypes; Humans; Immunosuppressive Agents - administration & dosage; Kidney Transplantation; Living Donors; Male; Medical sciences; Middle Aged; Recombinant Fusion Proteins - administration & dosage; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Rate; Tissue, organ and graft immunology; Steroid; Corticosteroid; Living donor; Transplantation; Monoclonal antibody; Homotransplantation; Induction treatment; Kidney; Quality of life; Immunomodulator; Medicine; Chemotherapy; Treatment; Urinary system; Surgery; Basiliximab; Immunotherapy; Graft; Immunosuppressive agent; Haplotype; Histocompatibility; Avoidance
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.09.156

Abstract Background Induction therapy and haplotype matching are utilized to mitigate immunologic risk in renal transplantation. The incidence of acute rejection (AR) of renal allografts has been reported to be as low as 9.3% within the first year among two-haplotype-matched siblings with no induction and triple-drug maintenance immunosuppression. We report our use of basiliximab induction in a series of two-haplotype-matched living donor renal transplants (LDRT). Methods We retrospectively reviewed 25 patients who received a two-haplotype-matched LDRT with basiliximab induction therapy. The primary endpoints were acute rejection (AR) episodes at 6 and 12 months and 1-year patient and graft survival rates. The secondary endpoints were the incidence of delayed graft function (DGF), cytomegalovirus (CMV), and BK virus (BKV). Results The rate of AR at 6 months was 0% (0/25) and 4% (1/25) at 12 months. The 1-year graft and patient survival rates were 100%. The incidence of DGF was 4% (1/25), while the incidences of CMV and BKV were 0%. Conclusion Basiliximab induction therapy with a steroid-sparing regimen yields favorable results in two-haplotype-matched LDRT, including a notable reduction in the rates of AR as compared to triple-drug maintenance immunosuppression without induction. These patients have excellent graft survival with no increased incidences of secondary infections.