Induction therapy with basiliximab allows delayed initiation of cyclosporine and preserves renal function after cardiac transplantation.

Published

Journal Article

BACKGROUND: Cyclosporine (CsA) is frequently initiated as induction therapy in patients undergoing orthotopic heart transplantation, but our experience has identified a significant rate of post-operative renal dysfunction. We therefore devised a renal-sparing cyclosporine-free induction regimen consisting of the early administration basiliximab, an interleukin-2 receptor monoclonal antibody, followed by the late initiation of cyclosporine on post-operative Day 4. METHODS: Between September 1998 and December 1999, we treated 25 patients at risk for post-operative renal dysfunction (high-risk basiliximab group) with the new induction regimen and another 33 patients not at risk (low-risk CsA group) for renal dysfunction with our standard cyclosporine protocol. We identified a historical control group (1996 through 1998) of 32 patients at risk for renal dysfunction (high-risk CsA group) who had received our standard cyclosporine protocol. RESULTS: The increase in serum creatinine levels after transplantation was less in the high-risk basiliximab group (-0.1 +/- 0.7) than in the high-risk CsA group (0.5 +/- 1.0, p < 0.02) and comparable to the low-risk CsA group (0.03 +/- 0.6). The basiliximab protocol did not increase rejection; the percentage of rejection episodes was high-risk basiliximab, 0; high-risk CsA, 13; and low-risk CsA, 3 (p = .13). CONCLUSION: Basiliximab induction therapy allows delayed initiation of cyclosporine after cardiac transplantation without an increase in rejection and reduces the risk of post-operative renal dysfunction.

Full Text

Duke Authors

Cited Authors

  • Rosenberg, PB; Vriesendorp, AE; Drazner, MH; Dries, DL; Kaiser, PA; Hynan, LS; Dimaio, JM; Meyer, D; Ring, WS; Yancy, CW

Published Date

  • September 2005

Published In

Volume / Issue

  • 24 / 9

Start / End Page

  • 1327 - 1331

PubMed ID

  • 16143252

Pubmed Central ID

  • 16143252

Electronic International Standard Serial Number (EISSN)

  • 1557-3117

Digital Object Identifier (DOI)

  • 10.1016/j.healun.2004.08.003

Language

  • eng

Conference Location

  • United States