title: Initial immunosuppression with or without basiliximab: a comparative study.
abstract: BACKGROUND
  Following liver transplantation, acute kidney injury (AKI) and chronic kidney disease occur in 20%-50% and 30%-90% of patients, respectively. Basiliximab, a chimeric monoclonal antibody, is highly effective to prevent rejection in organ transplant recipients, particularly among patients with renal dysfunction who benefit from delayed introduction of calcineurin inhibitors.
  
  
  OBJECTIVE
  The objective of this study was to measure the immunosuppressive effect of basiliximab and its impact on renal failure, lengths of hospital and intensive care unit (ICU) stays and prevalence of infection.
  
  
  METHODS
  From January 2010 through December 2011, we performed a controlled, nonrandomized study comparing two different immunosuppressive regimens: Group I, 36 transplantation on 34 patients, tacrolimus and corticosteroids de novo with mycophenolate mofetil in cases of renal failure; and Group II, 33 transplantation in 33 patients, corticosteriods and mycophenolate mofetil de novo with basiliximab on day 0 and day 4, and inception of tacrolimus on day 3.
  
  
  RESULTS
  Basiliximab patients (Group II) showed a significantly lower incidence of renal failure requiring replacement therapy (3.03% vs 25%; P = .014). The incidence of acute cellular rejection episodes treated with corticosteriod boluses was also significantly lower (3.03% vs 25%; P = .014). Bacterial, fungal, and cytomegalovirus infection rates were lower in Group II, although the differences were not significant. Similarly, Group II patients had an insignificantly shorter average stay in the hospital (25.9 vs 40.06 days) and the ICU (5.9 vs 8.17 days).
  
  
  CONCLUSIONS
  Basiliximab administration with delayed introduction of calcineurin inhibitors may be an effective strategy to reduce post-liver transplantation AKI requiring renal replacement therapy.
authors.affiliation: Hospital Ramón y Cajal, Madrid, Spain. r.martinmateos@me.com
authors.forename: R M
authors.initials: RM
authors.lastname: Martín-Mateos
authors.forename: J
authors.initials: J
authors.lastname: Graus
authors.forename: A
authors.initials: A
authors.lastname: Albillos
authors.forename: C
authors.initials: C
authors.lastname: Arocena
authors.forename: M A
authors.initials: MA
authors.lastname: Rodríguez Gandía
authors.forename: C
authors.initials: C
authors.lastname: Blesa
authors.forename: F
authors.initials: F
authors.lastname: García-Hoz
authors.forename: M
authors.initials: M
authors.lastname: García González
authors.forename: F J
authors.initials: FJ
authors.lastname: García-Alonso
authors.forename: R
authors.initials: R
authors.lastname: Bárcena
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000517:prevention & control*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D000077552:Basiliximab; D065095:Calcineurin Inhibitors; D016009:Chi-Square Distribution; D003141:Communicable Diseases / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D009173:Mycophenolic Acid; D016559:Tacrolimus