The selective use of basiliximab versus thymoglobulin in combination with sirolimus for cadaveric renal transplant recipients at low risk versus high risk for delayed graft function

Transplantation
R KnightBarry D Kahan

Abstract

We previously reported that the use of basiliximab together with sirolimus permits a window of recovery from delayed graft function before the introduction of reduced-dose cyclosporine. The present study reviews our experience with the substitution of thymoglobulin for basiliximab as induction therapy for recipients at increased risk for early acute rejection episodes. We retrospectively reviewed 145 cadaveric renal allograft recipients who received either basiliximab (n=115) or thymoglobulin (n=30) in combination with sirolimus and prednisone, followed by delayed introduction of reduced doses of cyclosporine. Recipients were stratified as high immune responders if they were African American, a retransplant recipient, or a recipient with a panel-reactive antibody greater than 50%. All other recipients were considered low immune responders. Basiliximab-treated high immune responders exhibited a higher incidence of acute rejection episodes (26%) than either basiliximab-treated low immune responders (10%, P=0.04) or thymoglobulin-treated high immune responders (3%, P=0.01). The median time to initiation of cyclosporine was 12 days; cyclosporine was initiated when the serum creatinine level was 2.5 mg/dL or less. Patients with earl...Continue Reading

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Citations

Jun 2, 2006·Springer Seminars in Immunopathology·Reinhard Marks, Jürgen Finke
Nov 7, 2007·Transplantation·Edmund HuangSuphamai Bunnapradist
May 24, 2008·Transplantation·Cheryle Gurk-TurnerAbdolreza Haririan
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Dec 29, 2007·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Iman BajjokaMarwan Abouljoud
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Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Anil Chandraker, Stefan G Tullius

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