Experience with basiliximab in pediatric renal transplantation

Vilalta, R.; Vila, Amparo Marquina; Nieto, Juliana Serrano; Español, Teresa; Caragol, Isabel; Callı́s, L

doi:10.1016/s0041-1345(01)02686-0

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…In a study of 346 adult patients, the addition of basiliximab to cyclosporine and steroids was well tolerated and reduced the number of AR episodes from 49.1% to 35.3% (P=0.009) within the 1st year after kidney transplantation [4,5]. Few data are available on the use of basiliximab induction for renal transplantation in children [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Basiliximab induction improves the outcome of renal transplants in children and adolescents

Swiatecka‐Urban¹,

Garcia

Feuerstein

et al. 2001

Pediatric Nephrology

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Thirty-two children and adolescents received their renal transplant at the Montefiore Medical Center, in New York, between October 1996 and May 2000. Twenty-four patients received basiliximab, in addition to tacrolimus and steroids (basiliximab group). The remaining eight patients received only tacrolimus and steroids (non-basiliximab group). The 1-year patient survival rate was 100% in both groups. The 1-year graft survival rate was 87.5% for the basiliximab group and 75% for the non-basiliximab group (P=0.45). The rates of acute rejection in the basiliximab and non-basiliximab groups were 26% and 43%, respectively (P=0.36). However, in recipients with

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Section: Introductionmentioning

confidence: 99%

Basiliximab induction improves the outcome of renal transplants in children and adolescents

Swiatecka‐Urban¹,

Garcia

Feuerstein

et al. 2001

Pediatric Nephrology

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“…Our immunosupressive regimen consisted of prednisolone, AZA, CsA initially and we added ATG in the CAD group. However, recently, FK506, was used instead of CsA in the CAD group and also basiliximab, was initiated (10, 11). AR rates were reported to be between 20–34% (12, 13).…”

Section: Discussionmentioning

confidence: 99%

Pediatric renal transplantation: Single center experience

Mır¹,

Erdoğan²,

Serdaroğlu³

et al. 2005

Pediatric Transplantation

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Although renal transplantation (RTx) is actually the first choice of treatment for children with end-stage renal disease, the number of transplanted children remains low in comparison with adults. The experience of the individual pediatric transplant center is very important in the outcome of pediatric transplant recipients. In this study, our pediatric renal transplantation experience is presented. We retrospectively analyzed the results of 72 pediatric renal transplants performed at Ege University Pediatric Nephrology Transplantation Center between June 1989 and May 2003. They were 40 girls, 32 boys and their mean RTx age was 13.27+/-3.73 yr (range 3-20 yr). Thirty-eight (52.8%) of the transplanted kidneys came from a living related donor, and 34 (47.2%) from a cadaveric donor. Preemptive RTx was performed in one patient and a second RTx was performed in one patient after two-period hemodialysis. Hypertension (31.9%), acute rejection (27.8%) and chronic rejection (13.9%) were the most common complications. Cytomegalovirus (CMV) infection occurred in 15 children (20.8%), none of whom died or lost their graft as a result of the infection. Pretransplant acquired hepatitis C virus (HCV) infection was detected in 12 patients (16.7%). Urinary tract infections (UTIs) were seen in 31 (43.1%) recipients. The 1, 5 and 10 yr graft survival rates were 91, 84 and 77%, respectively, and corresponding patient survival rates were 97, 84 and 77%, respectively by Kaplan-Meier method. The graft and overall survival was not correlated with sex, donor type, treatment modality, acute rejection episodes, hypertension, UTIs, CMV and HCV infection.

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“…[73,74] In basiliximab induction, cyclosporine, azathioprine, and corticosterboth studies, basiliximab was well tolerated and there were no oids (basiliximab group) were compared with the outcomes in 27 adverse events attributable to the use of basiliximab. In one study, historical control patients treated with ATG or ALG induction, 16% of children experienced acute rejection.…”

Section: Cyclosporine-based Immunosuppressionmentioning

confidence: 99%

“…[73] There were no cyclosporine, azathioprine, and corticosteroids (ATG/ALG reported acute rejection episodes in the second study. [74] group). [76] The biopsy-confirmed clinical acute rejection at 6…”

Section: Cyclosporine-based Immunosuppressionmentioning

confidence: 99%

Anti-Interleukin-2 Receptor Antibodies for the Prevention of Rejection in Pediatric Renal Transplant Patients

Swiatecka‐Urban

2003

Pediatric Drugs

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The anti-interleukin-2 receptor (anti-IL-2R) antibody therapy is an exciting approach to the prevention of acute rejection after renal allograft transplantation whereby immunosuppression is exerted by a selective and competitive inhibition of IL-2-induced T cell proliferation, a critical pathway of allorecognition. The anti-IL-2R antibodies specifically block the alpha-subunit of the IL-2R on activated T cells, and prevent T cell proliferation and activation of the effector arms of the immune system. The anti-IL-2R antibodies are used as induction therapy, immediately after renal transplantation, for prevention of acute cellular rejection in children and adults. During acute rejection, the IL-2Ralpha chain is no longer expressed on T cells; thus, the antibodies cannot be used to treat an existing acute rejection. Two anti-IL-2R monoclonal antibodies are currently in clinical use: daclizumab and basiliximab. In placebo-controlled phase III clinical trials in adults, daclizumab and basiliximab in combination with calcineurin inhibitor-based immunosuppression, significantly reduced the incidence of acute rejection and corticosteroid-resistant acute rejection without increasing the risk of infectious or malignant complications, and neither antibody was associated with the cytokine-release syndrome. Children who receive calcineurin inhibitors and corticosteroids for maintenance immunosuppression, as well as children who receive augmented immunosuppression to treat acute rejection, are at increased risk of growth impairment, hypertension, hyperlipidemia, lymphoproliferative disorders, diabetes mellitus, and cosmetic changes. In older children, the cosmetic adverse effects frequently reduce compliance with the treatment, and subsequently increase the risk of allograft loss. Being effective and well tolerated in children, the anti-IL-2R antibodies reduce the need for calcineurin inhibitors while maintaining the overall efficacy of the regimen; thus, the anti-IL-2R antibodies increase the safety margin (less toxicity, fewer adverse effects) of the baseline immunosuppression. Secondly, the anti-IL-2R antibodies decrease the need for corticosteroids and muromonab CD3 (OKT3) in children as a result of decreased incidence of acute rejection. The recommended pediatric dose of daclizumab is 1 mg/kg intravenously every 14 days for five doses, with the first dose administered within 24 hours pre-transplantation. This administration regimen maintains daclizumab levels necessary to completely saturate the IL-2Ralpha (5-10 microg/mL) in children for at least 12 weeks.The recommended pediatric dose of basiliximab for recipients <35 kg is 10 mg, and 20 mg for recipients > or =35 kg, intravenously on days 0 and 4 post-transplantation. This administration regimen maintains basiliximab levels necessary to completely saturate the IL-2Ralpha (>0.2 microg/mL) in children for at least 3 weeks.

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Experience with basiliximab in pediatric renal transplantation

Cited by 5 publications

References 10 publications

Basiliximab induction improves the outcome of renal transplants in children and adolescents

Basiliximab induction improves the outcome of renal transplants in children and adolescents

Pediatric renal transplantation: Single center experience

Anti-Interleukin-2 Receptor Antibodies for the Prevention of Rejection in Pediatric Renal Transplant Patients

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