The role of anti–IL-2 receptor in high-risk kidney transplant patients
| Autor: | S. Jirasiritham, V. Sumethkul, V. Mavichak, P. Lertsithichai |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Graft Rejection
Male Reoperation Nephrology medicine.medical_specialty Daclizumab Time Factors Basiliximab Recombinant Fusion Proteins Antibodies Monoclonal Humanized Gastroenterology Disease-Free Survival Internal medicine Living Donors medicine Humans IL-2 receptor Spouses Kidney transplantation Retrospective Studies Transplantation business.industry Histocompatibility Testing Incidence (epidemiology) Mortality rate Graft Survival Panel reactive antibody Antibodies Monoclonal Receptors Interleukin-2 Thailand medicine.disease Kidney Transplantation Survival Analysis Surgery Immunoglobulin G Female business Immunosuppressive Agents Follow-Up Studies medicine.drug |
| Zdroj: | Transplantation Proceedings. 36:2110-2112 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2004.08.088 |
| Popis: | Anti–IL-2 receptor has been proved to be effective in reducing the rate of acute rejection in kidney transplantation and also improving both the rate of graft and patient survival. In this study, we retrospectively review the role of anti–IL-2 receptor as induction immunosuppression in immunologically high-risk kidney transplant patient compared with normally low-risk patients. Methods From January 1999 to December 2002, we performed 246 kidney transplantations in two transplant centers in Bangkok. These were divided into two groups: group 1, high-risk group containing 50 patients who had one of the following criteria: (1) high panel reactive antibody (>50%); (2) retransplantation; (3) marginal donor (with expectancy of delayed graft function); (4) spouse donor; (5) >4 HLA mismatch. All group 1 patients receive anti–IL-2 receptor as induction immunosuppression (either Basiliximab ( n = 27) or Daclizumab ( n = 23).) Group 2 consisted of the control group of 196 patients with normal immunological risk. The following data of both groups were collected and analyzed: patient demography, type of donor, acute rejection incidence, severity, and time. Results In this study, the anti–IL-2 receptors are 27 cases of Basiliximab and 23 cases of Daclizumab. The rates of acute rejection are not significantly different in both groups, namely, 46 of 194 (23.7%) in group 2 compared with 10 of 50 (20%) episodes in group 1 ( P = .602). All rejections in both groups responded to pulse steroid treatment. The mortality rate and rate of graft failure were also not significantly different, i.e., 6 of 196 (3.1%) vs 2 of 50 (4.0%) ( P = .666) and 7 of 196 (3.6%) vs 3 of 50 (6.0%) ( P = .429) in low risk group versus high risk group, respectively. Kaplan-Meier estimates of the probabilities of acute rejection free, patient survival rate, and graft survival rate also showed no difference between groups. Conclusions The use of anti–IL-2 receptor antibodies as induction immunosuppression in immunologically high-risk patients results in the same rate of acute rejection, severity of acute rejection, graft survival, and patient survival as recipients with normal immunological risk. |
| Databáze: | OpenAIRE |
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