The outcome of induction therapy with monoclonal antibodies in kidney transplantation among Iranian patients: a prospective study

Transplant Proc. 2009 Sep;41(7):2768-71. doi: 10.1016/j.transproceed.2009.06.180.

Abstract

Introduction: The administration of interlukin-2 receptor antagonists for induction therapy has reduced the incidence of acute rejection episodes in kidney transplantation. Although some studies have investigated the efficacy of these monoclonal antibodies, there is little experience among Iranian kidney transplant recipients.

Materials and methods: Forty-three patients randomly divided into 2 groups were prospectively followed for 3.4 years. Eighteen patients received 2 doses of basiliximab (group I) and another 25 patients received 5 doses of daclizumab (group II). The posttransplantation complications, last serum creatinine level, as well as graft and patient survival rates were compared to investigate the efficacy of these therapies.

Results: Among 43 patients, 11.6% experienced acute rejection episodes: 22.2% in group I and 4% in group II (P > .05). In this study, 4.6% of recipients underwent graft nephrectomy: 11.1% in group I and 4% in group II (P > .05). The mortality rate was 4.6%: 5.5% in group I and 4% in group II (P > .05). The mean serum creatinine level was 1.47 +/- 0.7 mg/dL. Although it was lower in group I, the difference was not significant. The 1-year graft and patient survival rates were 90.6% and 95.3%, respectively, with no significant differences between the groups.

Discussion: Although induction therapy with monoclonal antibodies may reduce the incidence of acute rejection episodes, graft and patient survival rates were unchanged compared with conventional therapies. Also, there were no significant differences between the results of induction therapy with basiliximab and daclizumab.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Basiliximab
  • Cadaver
  • Creatinine / blood
  • Daclizumab
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival / drug effects
  • Graft Survival / physiology
  • Humans
  • Immunoglobulin G / therapeutic use*
  • Immunosuppressive Agents / therapeutic use*
  • Iran
  • Kidney Transplantation / immunology*
  • Kidney Transplantation / mortality
  • Living Donors
  • Male
  • Middle Aged
  • Nephrectomy
  • Prospective Studies
  • Recombinant Fusion Proteins / therapeutic use*
  • Survival Rate
  • Tissue Donors

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Immunoglobulin G
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Basiliximab
  • Creatinine
  • Daclizumab