Lack of economic benefit with basiliximab induction in living related donor adult renal transplant recipients.
OBJECTIVE
To assess the effect of basiliximab (BAS) induction therapy on acute rejection rates and overall costs in adult living related donor (LRD) renal transplant recipients. Design. Retrospective chart review and cost-effectiveness analysis of the first 12 months after transplantation.


METHODS
University hospital and outpatient renal transplant clinic.


METHODS
Sixty consecutive adult LRD renal transplant recipients.


METHODS
The treatment group received BAS 20 mg intravenously on postoperative days 0 and 4. The control group received no induction agents. Both groups received cyclosporine microemulsion, azathioprine, and corticosteroids for maintenance immunosuppression.


RESULTS
Six patients (three in each group) were excluded; three had received muromonab-CD3 as an induction agent and three were lost to follow-up. At 12-months, the frequency of acute rejection episodes was 15% (4/27) in the control group and 22% (6/27) in the BAS group (NS). Renal function, as measured by average serum creatinine level, was similar at months 1, 2, 3, 6, and 12 for both groups. The frequency of infectious complications was similar in both groups. No adverse effects were associated with BAS. Mean initial hospitalization charges were dollar 51,970.01 and dollar 68,093.90 in the control and BAS groups, respectively (p < 0.05). The control group had more readmissions (18 vs 14 in the BAS group), but the average charge/readmission was lower (dollar 10,148.50 vs dollar 21,952.58 in the BAS group; NS). All costs were adjusted to 2000 dollars (US).


CONCLUSIONS
Basiliximab induction therapy did not provide clear clinical efficacy benefit or prove to be cost-effective compared with no induction in LRD recipients.
Crompton
Jason A
JA
Solid Organ Transplant Program, College of Pharmacy , University of Utah, Salt Lake City, Utah 84132-2330, USA.
Somerville
Troy
T
Smith
Lonnie
L
Corbett
Jacke
J
Nelson
Edward
E
Holman
John
J
Shihab
Fuad S
FS
D000328:Adult; D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use; D000077552:Basiliximab; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D016030:Kidney Transplantation / Q000191:economics* / Q000706:statistics & numerical data; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D000911:Antibodies, Monoclonal; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab