[Clinical effect of induction therapy with monoclonal antibodies after deceased-donor kidney transplantation (an experience from Vilnius Center)].
We aimed at evaluating the impact of monoclonal antibodies on immune response against deceased-donor kidney transplant: the frequency and severity of acute rejection episodes during first 3 months after transplantation and graft loss rate at one year. The frequency of infectious complications during the first 6 months after transplantation and patient survival rate during one year were also analyzed. Our study included 187 deceased-donor renal transplants performed in Santariskes Clinics of Vilnius University Hospital from January 2000 to December 2004. Study group (Group 1) consisted of 66 patients who received additional induction therapy with monoclonal antibodies (31 patients treated with basiliximab and 35 patients treated with daclizumab); 121 patients in control group (Group 2) were treated only with conventional immunosuppression. Both groups received maintenance immunosuppressive therapy including cyclosporine, mycophenolate mofetil, and steroids. Patient and graft survival rates were calculated by Kaplan-Meier method. There were no significant differences in the age of patients, HLA mismatches, percentages of highly sensitized patients (panel-reactive antibody level more than 50%), and repeated transplantation between both groups. The incidence of biopsy-proven acute rejection during the first 3 months after transplantation was significantly lower in Group 1 than in Group 2 (15.2% vs. 28.1%, P<0.05). There were no significant differences in patient survival rates (95.5% vs. 90.1%) between two groups at one year, but graft survival rate was significantly higher in Group 1 than in Group 2 (94.0% vs. 77.0%, P<0.05). The proportion of patients with infectious complications during the first 6 months after transplantation was significantly lower in study group than in control group (33.3% vs. 49.6%, P<0.05). Therefore, induction therapy with monoclonal antibodies reduced the incidence and severity of acute rejection in early period after transplantation and led to higher graft survival rate. The lower frequency of infectious complications was observed in patients receiving induction therapy with monoclonal antibodies.
Rainiene
Tatjana
T
Santariskes Clinics of Vilnius University Hospital, Vilnius, Lithuania. taniged@zebra.lt
Dobrovolskiene
Rasa
R
Dainys
Balys
B
Kucinskis
Genadijus
G
Zelvys
Arūnas
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000077552:Basiliximab; D002102:Cadaver; D016009:Chi-Square Distribution; D002648:Child; D000077561:Daclizumab; D003627:Data Interpretation, Statistical; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D013997:Time Factors; D014019:Tissue Donors
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D000077561:Daclizumab