title: Use of simulect can reduce the incidence of acute rejection and demonstrates with superior 3-year patient and graft survival rates in renal transplantation.
abstract: BACKGROUND
  Acute rejection is a major cause of graft loss in renal transplantation. Because the highest risk for acute rejection is in the first month posttransplantation, improved prophylaxis could be most beneficial in this period. Simulect administration provides 30 to 45 days of immunoprophylaxis against acute rejection during the critical period after transplantation.
  
  
  OBJECTIVE
  We sought to assess the incidence of acute rejection episodes and the safety and tolerability of Simulect plus Neoral immunosuppression. Patient and graft survival rates up to 3 years posttransplantation were evaluated.
  
  
  METHODS
  Forty-one transplant recipients received Simulect by intravenous infusion of an initial 20-mg dose on the day of renal transplantation and a second 20-mg dose on day 4 posttransplant. All renal recipients received immunosuppression with Neoral and steroid.
  
  
  RESULTS
  There were eight cases (19.5%) of acute rejection within 1 year. The rejection episodes were easily reversed with steroid pulse therapy in seven patients except for graft loss. The 1-, 2-, and 3-year graft survival rates were 95%, 93%, and 88%, respectively. Overall, the 3-year patient survival rate was 100%.
  
  
  CONCLUSIONS
  Simulect in combination with Neoral and steroid-reduced the incidence of acute rejection without an increase in adverse events. The low incidence and severity of acute rejection may have led to the superior 3-year patient and graft survival rates in renal transplantation.
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
authors.forename: S-H
authors.initials: SH
authors.lastname: Chu
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Chiang
authors.forename: C-C
authors.initials: CC
authors.lastname: Huang
authors.forename: P-H
authors.initials: PH
authors.lastname: Lee
authors.forename: R-H
authors.initials: RH
authors.lastname: Hu
authors.forename: M-K
authors.initials: MK
authors.lastname: Lai
authors.forename: S-C
authors.initials: SC
authors.lastname: Chueh
authors.forename: M-K
authors.initials: MK
authors.lastname: Tsai
mesh_terms: D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012086:Reoperation; D016019:Survival Analysis
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab