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EnglishDual induction with low doses of rabbit anti-human thymoglobulin (RATG) and basiliximab effectively and safely prevented allograft rejection in high-risk renal transplant recipients. To assess whether treatment timing affects efficacy and tolerability, in this single-center, matched-cohort study, we compared posttransplant outcomes in 25 patients and 50 gender-, age-, and treatment-matched reference patients induced with the same course of 7 daily RATG infusions (0.5 mg/kg/day) started before or after engraftment, respectively. All subjects received basiliximab (20 mg) before and 4 days after transplantation, withdrew steroids within 6 days after surgery, and were maintained on steroid-free immunosuppression with cyclosporine and mycophenolate mofetil or azathioprine. Over 12 months after transplant, 1 patient (4%) and 13 reference patients (26%) had acute rejection episodes. One patient and 5 reference-patients required dialysis therapy because of delayed graft function. In all patients circulating CD4+ and CD8+ T lymphocytes were fully depleted before engraftment. Both treatments were well tolerated. In kidney transplantation, perioperative RATG infusion enhances the protective effect of low-dose RATG and basiliximab induction against graft rejection and delayed function, possibly because of more effective inhibition of early interactions between circulating T cells and graft antigens.
Perioperative minimal induction therapy: a further step toward more effective immunosuppression in transplantation / A. Gennarini, P. Cravedi, M. Marasà, A. Perna, G. Rota, M. Bontempelli, S. Sandrini, G. Remuzzi, P. Ruggenenti. - In: JOURNAL OF TRANSPLANTATION. - ISSN 2090-0007. - 2012(2012), pp. 426042.1-426042.7.
| Titolo: | Perioperative minimal induction therapy: a further step toward more effective immunosuppression in transplantation | |
| Autori: | REMUZZI, GIUSEPPE (Penultimo) | |
| Settore Scientifico Disciplinare: | Settore MED/14 - Nefrologia | |
| Data di pubblicazione: | 2012 | |
| Rivista: | ||
| Tipologia: | Article (author) | |
| Digital Object Identifier (DOI): | http://dx.doi.org/10.1155/2012/426042 | |
| Appare nelle tipologie: | 01 - Articolo su periodico |
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| File | Descrizione | Tipologia | Licenza | |
|---|---|---|---|---|
| 426042.pdf | Publisher's version/PDF | Open Access Visualizza/Apri |
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