Induction therapy with basiliximab allows delayed initiation of cyclosporine and preserves renal function after cardiac transplantation

Paul B. Rosenberg, Ank E. Vriesendorp, Mark H. Drazner, Daniel L. Dries, Patricia A. Kaiser, Linda S. Hynan, J. Michael Dimaio, Daniel Meyer, W. Steves Ring, Clyde W. Yancy

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Abstract

Background: Cyclosporine (CsA) is frequently initiated as induction therapy in patients undergoing orthotopic heart transplantation, but our experience has identified a significant rate of post-operative renal dysfunction. We therefore devised a renal-sparing cyclosporine-free induction regimen consisting of the early administration basiliximab, an interleukin-2 receptor monoclonal antibody, followed by the late initiation of cyclosporine on post-operative Day 4. Methods: Between September 1998 and December 1999, we treated 25 patients at risk for post-operative renal dysfunction (high-risk basiliximab group) with the new induction regimen and another 33 patients not at risk (low-risk CsA group) for renal dysfunction with our standard cyclosporine protocol. We identified a historical control group (1996 through 1998) of 32 patients at risk for renal dysfunction (high-risk CsA group) who had received our standard cyclosporine protocol. Results: The increase in serum creatinine levels after transplantation was less in the high-risk basiliximab group (-0.1 ± 0.7) than in the high-risk CsA group (0.5 ± 1.0, p < 0.02) and comparable to the low-risk CsA group (0.03 ± 0.6). The basiliximab protocol did not increase rejection; the percentage of rejection episodes was high-risk basiliximab, 0; high-risk CsA, 13; and low-risk CsA, 3 (p = .13). Conclusion: Basiliximab induction therapy allows delayed initiation of cyclosporine after cardiac transplantation without an increase in rejection and reduces the risk of post-operative renal dysfunction.

Original languageEnglish (US)
Pages (from-to)1327-1331
Number of pages5
JournalJournal of Heart and Lung Transplantation
Volume24
Issue number9
DOIs
Publication statusPublished - Sep 2005

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

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