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Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab
- Source :
- Cell Transplantation, Vol 21 (2012)
- Publication Year :
- 2012
- Publisher :
- SAGE Publishing, 2012.
-
Abstract
- Basiliximab is a recently developed immunosuppressive agent for the prevention of acute allograft rejection in renal transplant recipients. The combination use of basiliximab and a calcineurin inhibitor was suggested to be more effective in comparison to immunosuppressive therapy using calcineurin inhibitor without basiliximab. Cyclosporine has been generally administered with basiliximab for renal transplant recipients. However, in cases of tacrolimus-based immunosuppressive regimen, the clinical efficacy and safety of combined use of tacrolimus and basiliximab remains to be elucidated. This study evaluated the tacrolimus pharmacological efficacy using a lymphocyte immunosuppressant sensitivity test (LIST) with MTT assay procedures in 16 cases of renal transplant recipients treated by tacrolimus without basiliximab and in 13 cases treated by tacrolimus in combination with basiliximab. The rate of acute rejection episodes in the recipients treated with tacrolimus plus basiliximab was 1/13 (7.7%), whereas the rate in the recipients treated with tacrolimus without basiliximab was 6/16 (37.5%). The recipients were divided into two groups according to their peripheral blood mononuclear cell (PBMC) sensitivity to tacrolimus [i.e., including a tacrolimus high sensitivity group (IC50 50 >1.0 ng/ml). In the recipients treated with tacrolimus without basiliximab, the rate of acute rejection episodes in the tacrolimus high sensitivity group was 1/10 (10.0%), which was significantly lower than the rate in the low sensitivity group of 5/6 (83.3%; p = 0.008). The incidence of cytomegalovirus infection was not significantly different between the tacrolimus high and the low sensitivity groups of the recipients treated with tacrolimus with and without basiliximab. Therefore, in the case of selected tacrolimus-based immunosuppressive therapy for renal transplant recipients, the tacrolimus pharmacological efficacy should be evaluated using LIST at a time just before the transplant procedure in order to accurately predict allograft rejection. The data also suggested that low tacrolimus sensitivity recipients should be treated with tacrolimus-based immunosuppressive therapy in combination with basiliximab.
- Subjects :
- Adult
Graft Rejection
Male
medicine.medical_specialty
Basiliximab
medicine.medical_treatment
Lymphocyte
Recombinant Fusion Proteins
Calcineurin Inhibitors
Biomedical Engineering
Urology
lcsh:Medicine
chemical and pharmacologic phenomena
Peripheral blood mononuclear cell
Tacrolimus
Pharmacotherapy
medicine
Humans
Immunosuppression Therapy
Transplantation
business.industry
Calcineurin
Incidence
lcsh:R
Antibodies, Monoclonal
Immunosuppression
Cell Biology
Middle Aged
Kidney Transplantation
medicine.anatomical_structure
surgical procedures, operative
Pharmacodynamics
Cytomegalovirus Infections
Leukocytes, Mononuclear
Kidney Failure, Chronic
Drug Therapy, Combination
Female
business
Immunosuppressive Agents
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 15553892 and 09636897
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Cell Transplantation
- Accession number :
- edsair.doi.dedup.....594433ad69b8b16faa783ba976f077e2