251. Immunoprophylaxis with basiliximab compared with antithymocyte globulin in renal transplant patients receiving MMF-containing triple therapy.
- Author
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Lebranchu Y, Bridoux F, Büchler M, Le Meur Y, Etienne I, Toupance O, Hurault de Ligny B, Touchard G, Moulin B, Le Pogamp P, Reigneau O, Guignard M, and Rifle G
- Subjects
- Adult, Antibodies, Monoclonal adverse effects, Antilymphocyte Serum adverse effects, Basiliximab, Creatinine blood, Creatinine metabolism, Cyclosporine pharmacokinetics, Cyclosporine therapeutic use, Drug Therapy, Combination, Female, France, Graft Rejection epidemiology, Graft Rejection prevention & control, Humans, Kidney Failure, Chronic etiology, Kidney Failure, Chronic surgery, Kidney Transplantation physiology, Male, Middle Aged, Mycophenolic Acid analogs & derivatives, Racial Groups, Safety, Time Factors, Tissue Donors statistics & numerical data, Antibodies, Monoclonal therapeutic use, Antilymphocyte Serum therapeutic use, Immunosuppression Therapy methods, Kidney Transplantation immunology, Mycophenolic Acid therapeutic use, Recombinant Fusion Proteins
- Abstract
Acute graft rejection remains a major problem in renal transplant recipients, and there is no consensus on the optimal immunosuppressive strategy. Immunoprophylaxis with Thymoglobulin or basiliximab has significantly reduced the incidence of acute rejection episodes and graft loss following kidney transplantation. This open, randomized, multicenter study investigated the efficacy and tolerability of basiliximab (20mg day 0-day 4) plus early cyclosporine from day 0 (n = 50) compared with Thymoglobulin plus delayed cyclosporine (n = 50) in adult kidney transplant patients. In addition, all patients received steroids and mycophenolate mofetil (MMF) at standard doses from day 0. Patient and graft survival rates at 12 months were 98 and 94% in the basiliximab group, respectively, compared with 100 and 96% in the Thymoglobulin' group. The incidences of biopsy-confirmed acute rejection (8.0% in each group) and treatment failure (14% in the basiliximab group vs. 8% in the Thymoglobulin group) were comparable in the two groups. There was a non-significant tendency to more dialysis (14 vs. 6%), and fewer cytomegalovirus (CMV) infections (p = 0.005) in the basiliximab group, but the percentage of clinical CMV was not different between the two groups (6 vs. 12%). Both strategies give excellent results, despite the differences in patterns, in nonhyperimmunized patients receiving their first cadaveric renal allograft.
- Published
- 2002
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