Similar survival in patients following heart transplantation receiving induction therapy using daclizumab vs. basiliximab

Spencer T. Martin, Tomoko S. Kato, Maryjane Farr, Jaclyn T. McKeen, Faisal Cheema, Mengxi Ji, Alexandra Ross, Halit Yerebakan, Yoshifumi Naka, Hiroo Takayama, Susan Restaino, Donna Mancini, P. Christian Schulze

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Induction therapy with interleukin-2 receptor antagonists has been established as an effective im-munosuppressive strategy in the management of heart transplant (HTx) recipients. We compared outcomes following HTx in patients receiving basiliximab, daclizumab, or no induction therapy. Methods and Results: We investigated post-transplant prognosis of patients receiving basiliximab (n=67), dacli-zumab (n=98) or no induction therapy (n=70). Patients treated with daclizumab (50.3±14.7 years) were younger than those receiving basiliximab (55.8±11.2 years) or no induction therapy (54.9±14.1 years; both P<0.05). Patients receiving either induction therapy showed better survival 1 year after HTx (95%) than those without induction therapy (82%; P<0.001). Survival was similar between patients receiving basiliximab and daclizumab. The incidence of acute cellular or antibody-mediated rejections did not differ among the groups. The main reason that patients did not receive induction therapy was ongoing infection (65.7%), which was more common in patients on ventricular assist device (VAD) support than those without VAD (76.1% vs. 45.8%; P=0.004). The VAD-related infection rate in the entire study cohort was 29.7% (35/118 VAD recipients). Conclusions: Survival following HTx was worse in patients not receiving induction therapy. No differences were noted in survival or the incidence of rejection between the daclizumab- and basiliximab-treated groups. Induction therapy was less used in patients with infection, which was related to prior VAD support.

Original languageEnglish (US)
Pages (from-to)368-374
Number of pages7
JournalCirculation Journal
Volume79
Issue number2
DOIs
StatePublished - Jan 16 2015
Externally publishedYes

Keywords

  • Heart transplantation
  • Immunosuppressant
  • Induction therapy
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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