1. Daclizumab induction as an immunosuppressive regimen for renal transplant recipients from non-heart-beating donors.
- Author
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Sánchez-Fructuoso AI, Prats D, Marques M, Ridao N, Conesa J, García Mena M, Torrente J, and Barrientos A
- Subjects
- Adrenal Cortex Hormones therapeutic use, Antibodies, Monoclonal, Humanized, Cytomegalovirus Infections epidemiology, Daclizumab, Drug Therapy, Combination, Graft Rejection epidemiology, Graft Survival drug effects, Humans, Incidence, Kidney Transplantation mortality, Mycophenolic Acid therapeutic use, Postoperative Complications epidemiology, Retrospective Studies, Survival Rate, Tacrolimus therapeutic use, Antibodies, Monoclonal therapeutic use, Heart Arrest, Immunoglobulin G therapeutic use, Immunosuppressive Agents therapeutic use, Kidney Transplantation immunology, Mycophenolic Acid analogs & derivatives, Tissue Donors
- Abstract
Background: Recent reports have demonstrated the efficacy of interleukin-2-receptor blockers in lowering the incidence of early acute rejection. The present study aimed to test the hypothesis that the use of daclizumab induction (DAC) plus low-dose tacrolimus, mycophenolate mofetil, and steroid diminishes the incidence of delayed graft function (DGF) in renal transplants from non-heart-beating donors (NHBD)., Methods: We compared the incidence of DGF and rejection in 185 renal transplants from NHBD treated as follows: Group-I: quadruple sequential therapy with antithymocyte globulin, cyclosporine, azathioprine, and steroids (n=22); Group-II: cyclosporine (8 mg/kg/d) plus azathioprine plus steroid (n=26); Group-III: low-dose cyclosporine (5 mg/kg/d) plus mycophenolate mofetil plus steroid (n=68); Group-IV: low-dose tacrolimus (0.1 mg/kg/d) plus mycophenolate mofetil plus steroid (n=17); and Group-V: DAC plus low-dose tacrolimus plus mycophenolate mofetil plus steroid (n=43)., Results: The incidences of DGF were 72.7% in Group-I, 73.1% in Group-II, 69.1% in Group-III, 76.5% in Group-IV, and 44.2% in Group-V. Acute rejection was higher in Group-IV., Conclusions: The combination of DAC, low-dose tacrolimus, mycophenolate mofetil, and steroids is effective in lowering the incidence of DSF in NHBD kidney transplant recipients without any increase in acute rejection.
- Published
- 2003
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