Induction therapy with interleukin-2 receptor antagonist after intestinal transplantation is associated with reduced acute cellular rejection and improved renal function

Farmer, Douglas G.; McDiarmid, Suzanne V.; Edelstein, Susan; Renz, John F.; Hisatake, Garrett M.; Cortina, Galen; Fondevila, Constantino; Corrêa, Maria Clara Medina; Rhodes, Shannon; Zafar, Atif; Chavez, Yamile Haito; Yersiz, Hasan; Busuttil, Ronald W.

doi:10.1016/j.transproceed.2004.01.099

Cited by 18 publications

(4 citation statements)

References 5 publications

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“…Antilymphocyte antibody therapies in the form of rabbit antithymocyte globulin (rATG, Thymoglobulin, Genzyme Corp., Cambridge, MA) and alemtuzumab (Campath‐1H, Genzyme Corp., Cambridge, MA) have both been reported in single center publications to be associated with improved short‐term survival and decreased rejection rates and severity (10–12). Likewise, induction with interleukin‐2 receptor antagonists (daclizumab [Zenapax, Roche Group, Nutley, NJ)] or basiliximab [Simulect, Novartis, Basel, Switzerland]) has been associated with similar improvements in survival and reduction in acute rejection episodes and their severity (13,14).…”

Section: Patient and Graft Survival Early Versus Latementioning

confidence: 99%

Intestine Transplantation in the United States, 1999-2008

Mazariegos

Steffick

Horslen

et al. 2010

American Journal of Transplantation

129

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Improving short-term results with intestine transplantation have allowed more patients to benefit with nearly 700 patients alive in the United States with a functioning allograft at the end of 2007. This success has led to an increase in demand. Time to transplant and waiting list mortality have significantly improved over the decade, but mortality remains high, especially for infants and adults with concomitant liver failure. The approximately 200 intestines recovered annually from deceased donors represent less than 3% of donors who have at least one organ recovered. Consent practice varies widely by OPTN region. Opportunities for improving intestine recovery and utilization include improving consent rates and standardizing donor selection criteria. One-year patient and intestine graft survival is 89% and 79% for intestineonly recipients and 72% and 69% for liver-intestine recipients, respectively. By 10 years, patient and intestine survival falls to 46% and 29% for intestine-only recipients, and 42% and 39% for liver-intestine, respectively.Immunosuppression practice employs peri-operative antibody induction therapy in 60% of cases; acute rejection is reported in 30%-40% of recipients at one year. Data on long-term nutritional outcomes and morbidities are limited, while the cause and therapy for late graft loss from chronic rejection are areas of ongoing investigation.

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Section: Patient and Graft Survival Early Versus Latementioning

confidence: 99%

Intestine Transplantation in the United States, 1999-2008

Mazariegos

Steffick

Horslen

et al. 2010

American Journal of Transplantation

129

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“…Induction strategies to minimize rejection by reducing the recipient's T-cell load were implemented, initially with cyclophosphamide induction therapy, which was later replaced by daclizumab, an interleukin-2 receptor antagonist (IL2RA) [33]. Basiliximab, another IL2RA, in addition to tacrolimus and prednisone immunosuppression has also been utilized and shown to decrease the incidence of acute rejection [34,35].…”

Section: Immunosuppressionmentioning

confidence: 99%

Autologous Intestinal Reconstruction Surgery

2011

Clinical Management of Intestinal Failure

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Intestinal transplantation (ITx) has evolved in the past few decades moving from an experimental procedure to a life-changing modality for patients suffering from intestinal failure (IF). It is particularly for those with complications as a consequence of parenteral nutrition and/or who have a high risk of dying due to their underlying disease. In addition to this, intestinal transplantation is also increasingly considered for the treatment of conventionally unresectable abdominal tumors. With advancements in immunosuppressive drugs, induction regimens, standardization of surgical techniques and improved postoperative care, survival is increasing. The ultimate goal for intestinal transplantation would be to become as good and safe as total parenteral nutrition (TPN) and as such, it could become a viable first-line option of intestinal failure.

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“…By the use of induction antibody therapies directed against interleukin-a-2 receptors (IL-2-Rs) it has become possible to remove specific subsets which block the response to new antigens whilst preserving the 'established' immune defences. Following the use of this induction treatment, several programs have reported improved results [20][21][22]. Data from the Intestinal Transplant Registry showed that the use of IL-2-Rs improved survival (P ¼ 0.0182) [1].…”

Section: Immune Modulationmentioning

confidence: 99%