Long-term results of basiliximab induction immunosuppression in pediatric liver transplant recipients.
It has been shown that an induction therapy with the monoclonal anti-interleukin-2 receptor antibody basiliximab (Simulect) is capable to reduce the incidence of acute graft rejection in adult and pediatric liver transplantation (Ltx). However, data on long-term results using basiliximab in children post-Ltx are still pending. Therefore, the objective of our study was to report on the long-term results of basiliximab induction therapy in pediatric liver transplant recipients. A total of 54 children received two single doses of basiliximab in addition to cyclosporine and prednisolone following Ltx. We analyzed the incidence of acute and chronic graft rejection that of post-transplant lymphoproliferative disease (PTLD), and patient and graft survival. The follow-up was 22-46 months. The historical control group (matched controls) consisted of 54 patients treated with a cyclosporine and prednisolone dual therapy. Patient survival was 53 of 54 in the treatment group and 51 of 54 in the controls. One patient was retransplanted in the treatment group vs. three patients in the control group. The incidence of acute graft rejection was 16.6% compared with 53.7% in the control group (p < 0.001), that of chronic rejection was comparable in both groups (one of 54 vs. one of 54). The incidence of steroid resistant rejection was four of 54 vs. six of 54 that of PTLD were one of 54 vs. zero of 54. There were no adverse effects observed, which could be related to the antibody treatment. We conclude that basiliximab provides safe and effective induction immunosuppression in pediatric liver graft recipients. Short- and even long-term results are excellent.
Ganschow
Rainer
R
Department of Pediatrics, University of Hamburg, Germany .
Grabhorn
Enke
E
Schulz
Andrea
A
Von Hugo
Alexander
A
Rogiers
Xavier
X
Burdelski
Martin
M
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology; D006085:Graft Survival / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D007223:Infant; D007239:Infections / Q000453:epidemiology; D016031:Liver Transplantation / Q000276:immunology* / Q000401:mortality; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D016019:Survival Analysis; D013997:Time Factors
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab