Basiliximab induction improves the outcome of renal transplants in children and adolescents

Byline: A. Swiatecka-Urban (1), Clotilde Garcia (2), Dianne Feuerstein (3), Samuel Suzuki (4), Prasad Devarajan (2), Richard Schechner (3), Stuart Greenstein (3), Vivian Tellis (3), Frederick Kaskel (2) Keywords: Keywords Basiliximab; Tacrolimus; Target levels; Post-transplant lymphoproliferative disease; Post-transplant diabetes mellitus Abstract: Thirty-two children and adolescents received their renal transplant at the Montefiore Medical Center, in New York, between October 1996 and May 2000. Twenty-four patients received basiliximab, in addition to tacrolimus and steroids (basiliximab group). The remaining eight patients received only tacrolimus and steroids (non-basiliximab group). The 1-year patient survival rate was 100% in both groups. The 1-year graft survival rate was 87.5% for the basiliximab group and 75% for the non-basiliximab group (P=0.45). The rates of acute rejection in the basiliximab and non-basiliximab groups were 26% and 43%, respectively (P=0.36). However, in recipients with a$?3 HLA mismatches, the rate of acute rejection was zero in the basiliximab group, and 40% in the non-basiliximab group (P=0.04). The beneficial effect occurred despite the fact that tacrolimus was maintained at below the target levels. There were no adverse events directly attributable to the administration of basiliximab. There were no cases of opportunistic infections or post-transplant lymphoproliferative disease. In summary, addition of basiliximab to tacrolimus and prednisone significantly decreased the rate of acute rejection in well-matched patients. Moreover, this effect was manifest at lower, and therefore less toxic, tacrolimus levels. Author Affiliation: (1) Ira Greifer Pediatric Kidney Center, 3326 Bainbridge Avenue, Bronx, NY 10467, USA. ajaswurban001@worldnet.att.net, US (2) Department of Pediatrics, Division of Nephrology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, USA, US (3) Department of Surgery, Division of Transplantation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA, US (4) Department of Biomedical Statistics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA, US Article note: Received: 19 December 2000 / Revised: 23 April 2001 / Accepted: 24 April 2001