title: Anti-CD25 monoclonal antibody coverage allows for calcineurin inhibitor "holiday" in solid organ transplant patients with acute renal dysfunction.
abstract: BACKGROUND
  Solid organ transplant (Tx) patients on calcineurin inhibitors (CNI) can develop acute renal dysfunction (ARD), which could be improved by reducing or withholding ("holiday") CNI dose.
  
  
  METHODS
  We used anti-CD25 monoclonal antibodies to prevent acute rejection in 11 adult Tx patients (7 heart, 2 liver, 2 heart-renal Tx), requiring a CNI "holiday" because of 15 events of ARD after the initial postTx hospitalization. An event of ARD was defined as an increase in serum creatinine (Scr)>25% vs. baseline. The CNI "holiday" was implemented until Scr had decreased to baseline. Basiliximab was used in 7 patients (11 events), and daclizumab was used in 4 patients (4 events).
  
  
  RESULTS
  The CNI "holiday" was implemented over 21+/-51 days. Anti-CD25 mAb were well tolerated with no episodes of acute rejection. Scr (micromol/liter) increased from 145+/-48 to 301+/-92 (P<0.0001), and decreased to 143+/-55 with the CNI "holiday."
  
  
  CONCLUSIONS
  Our results suggest that a CNI "holiday" may improve ARD after solid organ Tx without rejection under anti-CD25 mAb coverage.
authors.affiliation: Department of Medicine, Division of Transplantation, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, H3A 1A1, Canada.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Cantarovich
authors.forename: Peter
authors.initials: P
authors.lastname: Metrakos
authors.forename: Nadia
authors.initials: N
authors.lastname: Giannetti
authors.forename: Renzo
authors.initials: R
authors.lastname: Cecere
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Barkun
authors.forename: Jean
authors.initials: J
authors.lastname: Tchervenkov
mesh_terms: D000208:Acute Disease; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000077552:Basiliximab; D065095:Calcineurin Inhibitors; D003404:Creatinine / Q000097:blood; D000077561:Daclizumab; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D015375:Receptors, Interleukin-2 / Q000276:immunology*; D011993:Recombinant Fusion Proteins
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D065095:Calcineurin Inhibitors; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D015375:Receptors, Interleukin-2; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D003404:Creatinine; D000077561:Daclizumab