Basiliximab versus rabbit anti-thymocyte globulin for induction therapy in patients after heart transplantation.
BACKGROUND
The use of basiliximab or rabbit anti-thymocyte globulin (RATG) for induction therapy has significantly reduced the incidence of acute rejection episodes post-transplantation. The purpose of this study was to compare the safety and efficacy of basiliximab vs RATG in a population of adult heart transplant recipients.


METHODS
We retrospective analyzed the safety and efficacy of basiliximab compared with RATG among 48 adult heart transplant recipients at our center. Twenty-five patients received basiliximab (20 mg on days 0 and 4 after heart transplantation), and 23 patients received RATG (1.5 mg/kg for 3 days). A standard triple-drug immunosuppression regimen was administered to all patients.


RESULTS
The average biopsy score (ABS) at 1 month was 0.79 +/- 0.18 in the Basiliximab Group vs 0.47 +/- 0.2 in the RATG group (p = 0.023) and at 3 months was 0.75 +/- 0.24 in the Basiliximab Group vs 0.46 +/- 0.12 in the RATG Group (p = 0.032). At 6 months after transplantation, the difference between groups was not statistically significant (0.97 +/- 0.23 vs 0.58 +/- 0.17, p = .14). At 12 months the ABS was 0.85 +/- 0.4 in the Basiliximab Group vs 0.63 +/- 0.15 in the RATG Group (p = 0.12), and the number of episodes of infection was similar in both groups (19 vs 26; p = 0.16). There was no correlation between cumulative cyclosporine doses and rejection. Creatinine clearance levels were not statistically different between groups at baseline and up to 12 months after heart transplantation. Three patients died in the Basiliximab Group, and 2 patients died in the RATG Group.


CONCLUSIONS
Rabbit anti-thymocyte globulin is more effective than basiliximab for prevention of rejection episodes after heart transplantation. Both induction agents provide similar safety profile.
Flaman
Flavia
F
Division of Cardiology and Transplant, Toronto General Hospital, Toronto, Ontario, Canada.
Zieroth
Shelley
S
Rao
Vivek
V
Ross
Heather
H
Delgado
Diego H
DH
D000328:Adult; D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000961:Antilymphocyte Serum / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000077552:Basiliximab; D001706:Biopsy; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control*; D016027:Heart Transplantation / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011817:Rabbits; D011993:Recombinant Fusion Proteins / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab