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Can daclizumab reduce acute rejection and improve long-term renal function in tacrolimus-based primary renal transplant recipients?
- Source :
-
Nephrology (Carlton, Vic.) [Nephrology (Carlton)] 2008 Jun; Vol. 13 (3), pp. 251-5. Date of Electronic Publication: 2008 Jan 23. - Publication Year :
- 2008
-
Abstract
- Aims: To evaluate the efficacy and safety of a tacrolimus-based immunosuppressive regimen with and without induction therapy using daclizumab in first cadaveric renal transplant recipients.<br />Methods: Since January 2001, we studied the effect of daclizumab in a non-randomized and prospective study of 36 sequential first cadaveric renal transplant recipients. They were compared with a historical control group of 21 sequential first cadaveric renal transplant recipients without induction therapy. All patients received tacrolimus, azathioprine and corticosteroids as concomitant immunosuppressive therapy. Daclizumab was given at 1 mg/kg infusion 2 h before transplantation and then every 14 days for four more doses. Outcomes measured included incidence of acute rejection, patient survival, graft survival, annualized change in creatinine clearance (CrCl), cardiovascular risk profile, infection and malignancy.<br />Results: Fewer biopsy proven acute rejections were observed in the induction treatment group: 11.1% (4/36) versus 19% (4/21) but the rejection free survival was similar (P = 0.37). The patient survival and graft survival were comparable. The renal function was similar in both groups. There were also no significant difference in infection, malignancy and cardiovascular risk profile in both groups.<br />Conclusion: Adding daclizumab to a tacrolimus-based therapy is safe but cannot further improve clinical efficacy.
- Subjects :
- Acute Disease
Adrenal Cortex Hormones therapeutic use
Adult
Antibodies, Monoclonal adverse effects
Antibodies, Monoclonal, Humanized
Azathioprine therapeutic use
Cardiovascular Diseases etiology
Creatinine metabolism
Daclizumab
Drug Therapy, Combination
Female
Graft Rejection mortality
Graft Rejection physiopathology
Humans
Immunoglobulin G adverse effects
Immunosuppressive Agents adverse effects
Kidney metabolism
Kidney physiopathology
Kidney surgery
Male
Middle Aged
Neoplasms etiology
Opportunistic Infections etiology
Prospective Studies
Tacrolimus adverse effects
Time Factors
Treatment Outcome
Antibodies, Monoclonal therapeutic use
Graft Rejection prevention & control
Immunoglobulin G therapeutic use
Immunosuppressive Agents therapeutic use
Kidney drug effects
Kidney Transplantation mortality
Tacrolimus therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1797
- Volume :
- 13
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Nephrology (Carlton, Vic.)
- Publication Type :
- Academic Journal
- Accession number :
- 18221256
- Full Text :
- https://doi.org/10.1111/j.1440-1797.2007.00911.x