Single centre experience with basiliximab in paediatric renal transplantation.
BACKGROUND
Introduction of IL-2-receptor antagonists has led to significantly decreasing numbers of acute rejection episodes in renal transplantation in adults. No data are available in paediatric recipients.


METHODS
Between 1997 and 2000, 78 renal transplantations were performed in 77 children aged 0.5-16 years. Basiliximab, cyclosporin A (CsA) and prednisolone were administered in 48 children (age 7.8 +/- 5.3 years) and compared with 29 children (age 7.3 +/- 5.2 years) receiving CsA and prednisolone only. The number of acute rejections, survival, glomerular filtration rate (GFR) and side effects were determined for 3 years after transplantation.


RESULTS
All 77 patients survived the observation period. One year graft survival in the basiliximab group was 95%, which is similar to the comparison group (93%). Children receiving basiliximab showed a lower incidence of acute rejection than the comparison group (14% vs 34%). The calculated GFR was lower in the basiliximab group when discharging from hospital, with 51 compared with 66 ml/min/1.73 m(2) in the non-basiliximab group. This was associated with higher CsA trough levels (214 vs 174 ng/ml) in the basiliximab patients. After 1 year the GFR was comparable in both groups (58 vs 52 ml/min/1.73 m(2)).


CONCLUSIONS
Basiliximab offers excellent allograft survival, a lower incidence of acute rejections and almost no side effects. Therefore it can be recommended for routine immunosuppressive therapy in paediatric renal transplantation.
Pape
Lars
L
Department of Paediatric Nephrology, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30623 Hannover, Germany. larspape@t-online.de
Strehlau
Juergen
J
Henne
Thomas
T
Latta
Kay
K
Nashan
Bjoern
B
Ehrich
Jochen H H
JH
Klempnauer
Juergen
J
Offner
Gisela
G
D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D007223:Infant; D016030:Kidney Transplantation; D011182:Postoperative Care; D011239:Prednisolone / Q000627:therapeutic use; D011300:Preoperative Care; D011993:Recombinant Fusion Proteins; D016019:Survival Analysis
D000911:Antibodies, Monoclonal; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D016572:Cyclosporine; D000077552:Basiliximab; D011239:Prednisolone