Basiliximab (Simulect) in renal transplantation with high risk for delayed graft function.
BACKGROUND
Basiliximab (Simulect) is effective in reducing episodes of acute rejection in renal transplantation. Delayed graft function (DGF) predisposes to acute rejection and shortens graft survival. The aim of this study was to determine the effects of basiliximab in renal transplantation recipients at high risk for DGF.


METHODS
We studied 87 patients (mean age, 59 years), 42 of whom received basiliximab, 20 mg before transplantation and 20 mg on day 4. This cohort was compared with 45 patients without basiliximab. All received cyclosporine (51%) or tacrolimus (49%), mycophenolate mofetil, and steroids. DGF was defined as the requirement for dialysis within the first week after transplantation or failure to improve preexisting renal function. High-risk factors for DGF were cold ischemia time, recipient and donor age, non-heart-beating donor, HLA matching, and panel reactive antibody (PRA).


RESULTS
The incidence of DGF was 18 (43%) in the basiliximab group versus 28 (62%) in the other patients (P = .07). When allografts from non-heart-beating donors were excluded, this incidence was 14 (38%) in the basiliximab group versus 28 (62%) in the other patients (P = .04). Regression analysis showed basiliximab to be a protective factor: 0.26 (range, 0.09-0.76). Basiliximab was well tolerated, and complications were similar in both groups.


CONCLUSIONS
Basiliximab reduced the incidence of DGF in patients who received a high-risk allograft. It was well tolerated, and no adverse events were reported. The use of basiliximab may be considered in patients receiving an allograft who are at high risk for DGF.
Fernandez Rivera
C
C
Department of Nephrology, Hospital Juan Canalejo, A Coruña, Spain. constantino_rivera@canalejo.org
Alonso Hernandez
A
A
Villaverde Verdejo
P
P
Oliver García
J
J
Valdés Cañedo
F
F
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D004359:Drug Therapy, Combination; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology / Q000502:physiology*; D006323:Heart Arrest; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D008875:Middle Aged; D011184:Postoperative Period; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012083:Renin / Q000097:blood; D012189:Retrospective Studies; D014019:Tissue Donors
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D012083:Renin