title: Repeated daclizumab administration to delay the introduction of calcineurin inhibitors in heart transplant patients with postoperative renal dysfunction.
abstract: Daclizumab is an interleukin-2 receptor antagonist which is used for induction therapy in heart transplant patients. It has few side effects and is associated with a low infection rate. Postoperative renal failure after heart transplantation is common and potentially fatal. The administration of calcineurin inhibitors in the postoperative period can aggravate the situation. We report the cases of six patients who underwent heart transplantation and developed acute renal failure in the immediate postoperative period. All were administered daclizumab weekly to avoid the introduction of calcineurin inhibitors and to facilitate recovery of renal function. Calcineurin inhibitors were introduced only once renal function had improved. Renal function recovered in all cases and there was a low complication rate. The administration of repeated doses of daclizumab to patients who experience acute postoperative renal failure after heart transplantation may provide an alternative therapeutic approach that enables calcineurin inhibitors to be avoided and, consequently, renal function to recover.
authors.affiliation: Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario La Fe, Valencia, España.
authors.forename: Ignacio J
authors.initials: IJ
authors.lastname: Sánchez Lázaro
authors.forename: Luis
authors.initials: L
authors.lastname: Almenar Bonet
authors.forename: Luis
authors.initials: L
authors.lastname: Martínez Dolz
authors.forename: Francisco
authors.initials: F
authors.lastname: Buendía Fuentes
authors.forename: Josep
authors.initials: J
authors.lastname: Navarro Manchón
authors.forename: Jaime
authors.initials: J
authors.lastname: Agüero Ramón-Llin
authors.forename: José Luis
authors.initials: JL
authors.lastname: Vicente Sánchez
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvador Sanz
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy*; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D065095:Calcineurin Inhibitors; D000077561:Daclizumab; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy*; D013997:Time Factors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D065095:Calcineurin Inhibitors; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D000077561:Daclizumab