The Use of Long-Term Monthly Basiliximab Infusions as Rescue Maintenance Immunosuppression in Pancreas Transplant Recipients.

Autor: Chen JM; Department of Pharmacy, IU Health, Indianapolis, Indiana, USA., Mangus RS; Department of Surgery, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA., Sharfuddin AA; Department of Nephrology, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA., Powelson JA; Department of Surgery, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA., Yaqub MS; Department of Nephrology, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA., Adebiyi OO; Department of Nephrology, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA., Jan MY; Department of Nephrology, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA., Lutz AJ; Department of Surgery, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA., Fridell JA; Department of Surgery, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2024 Dec; Vol. 38 (12), pp. e70050.
DOI: 10.1111/ctr.70050
Abstrakt: This single-center retrospective study was designed to evaluate the use of basiliximab as an alternative rescue maintenance immunosuppression in situations where standard maintenance immunosuppression is not tolerated after a pancreas transplant. All pancreas transplants performed between January 11, 2006, and January 6, 2022, were reviewed. All recipients received rabbit antithymocyte globulin (rATG) induction with tacrolimus + sirolimus maintenance for simultaneous pancreas and kidney (SPK) and additional low-dose mycophenolic acid for pancreas transplant alone (PTA). Basiliximab 40mg IV q 4 weeks was either added to or in replacement of adjunct immunosuppression in cases of medication intolerance. All recipients who received ≥3 months of basiliximab with ≥1 year follow-up were included. 29/557 (5.2%) recipients (5 SPK and 24 PTA) were identified. Median time to switch was 13 months. When compared 1:2 to matched controls on standard immunosuppression, there was no difference in pancreas rejection, allograft loss, or mortality. Eleven recipients had 13 episodes of pancreas rejection at a median of 28 months post conversion. Eight pancreas allografts failed at a median of 28 months post conversion, and there were five deaths-all occurring in PTA, 4/5 occurring ≥1 year after discontinuation of basiliximab. Renal allograft rejection occurred in one SPK and there was one renal allograft loss. Five PTA developed renal failure. Ten remain on basiliximab (2/5 SPK, 8/24 PTA) at a median of 44 months with good pancreas and kidney function; 4 pts > 4 years. Basiliximab can be considered an alternative rescue maintenance strategy in pancreas transplant recipients who failed other conventional agents.
(© 2024 The Author(s). Clinical Transplantation published by Wiley Periodicals LLC.)
Databáze: MEDLINE
Externí odkaz: