Comparison of Basiliximab and Daclizumab With Triple Immunosuppression in Renal Transplantation

• Published in: Transplantation proceedings Vol. 43; no. 2; pp. 453 - 457
• Main Authors: Aktas, S, Colak, T, Baskin, E, Sevmis, S, Ozdemir, H, Moray, G, Karakayali, H, Haberal, M
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.03.2011; Elsevier
• Subjects: Adrenal Cortex Hormones - pharmacology; Adult; Antibodies, Monoclonal - chemistry; Antibodies, Monoclonal - pharmacology; Antibodies, Monoclonal, Humanized; Biological and medical sciences; Cyclosporine - pharmacology; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Survival; Humans; Immunoglobulin G - pharmacology; Immunosuppression - methods; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - methods; Male; Medical sciences; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - pharmacology; Receptors, Interleukin-2 - metabolism; Recombinant Fusion Proteins - pharmacology; Risk Factors; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; T-Lymphocytes - immunology; Tacrolimus - pharmacology; Tissue, organ and graft immunology; Drug combination; Monoclonal antibody; Homotransplantation; Kidney; Daclizumab; Immunomodulator; Medicine; Treatment; Urinary system; Surgery; Basiliximab; Immunotherapy; Graft; Immunosuppressive agent; Comparative study; Kidney transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.01.075

Abstract Purpose Graft rejection is a serious problem despite immunosuppressive agents. Immunosuppression has been achieved with monoclonal antibodies (mAb) that bind specifically to the α subunit of the interleukin (IL)-2 receptor present on activated T lymphocytes. We explored the effects of two of the mAbs–daclizumab and basiliximab–on graft function. Materials and methods Our 1543 renal transplant recipients received baseline therapy with cyclosporine or tacrolimus plus corticosteroids and mycophenolate mofetil. In addition standard dosages intravenously of daclizumab ( n = 156) or basiliximab ( n = 45) in were administered intravenously to 201 renal transplant patients who included 122 men and 79 women of overall mean age of 30 ± 13.7 years. Results Patient and donor characteristics including age, sex, causes of renal failure, presence of comorbidities, panel-reactive antibodies, and numbers of human leukocyte antigen–mismatched were similar between the groups. During a mean follow-up of 27 ± 20 months, biopsy-proven acute rejection was observed in three patients in the basiliximab group and 23 in the daclizumab group. Cytomegalovirus infection occurred in 13 patients. There was no case of posttransplant lymphoproliferative disorder. Three polyoma BK nephropathies were detected in the daclizumab group. No hypersensitivity reaction occurred in either group. One-year patient survival was 100% in the basiliximab group and 99% in the daclizumab group, with graft survivals of 95% versus 94%, respectively. The mean creatinine levels at discharge were 2 mg/dL versus 2.3 mg/dL and at 12 months, 1.3 mg/dL versus 1.2 mg/dL, respectively. Conclusions Acute rejection episodes remain a significant risk factor for the development of graft dysfunction and poor long-term graft survival. IL-2R antagonists were effective antibody therapies. There was no apparent difference between basiliximab and daclizumab treatment.