Back to Search Start Over

Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab

Authors :
Kentaro Sugiyama Ph.D.
Kazuya Isogai
Satoshi Horisawa
Akira Toyama
Hiroshi Satoh
Kazuhide Saito
Yuki Nakagawa
Masayuki Tasaki
Kota Takahashi
Toshihiko Hirano
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 (IC 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

Subjects :
Medicine

Details

Language :
English
ISSN :
09636897 and 15553892
Volume :
21
Database :
Directory of Open Access Journals
Journal :
Cell Transplantation
Publication Type :
Academic Journal
Accession number :
edsdoj.21dafdf17c7e409bb009ffdf634ae830
Document Type :
article
Full Text :
https://doi.org/10.3727/096368911X605493