The effect of the applied induction immunosuppressive therapy protocol on the allografted kidney condition

Abstract

To assess the Eculizumab effect on the allografted kidney function in the immediate and early postoperative period. Materials and methods: In kidney transplantation, 33 patients received Eculizumab in combination with Alemtuzumab (group 1). Other 38 patients (group 2) were enrolled for a comparative analysis. They received their induction immunosuppressive therapy with Alemtuzumab and plasmapheresis sessions. The following parameters were used for analysis: the urine output in the first 24 hours after surgery, the period of creatinine level drop to 3 mg/dL, a 24-hour protein excretion at day 30 after surgery, a glomerular filtration rate at day 30 after transplantation, histology of kidney allograft biopsy at 1 month post surgery. Results: A comparative analysis has demonstrated much lower values of 24 hour proteinuria in group 1 than in group 2. As to the glomerular filtration rate, it was 1.9 times higher in group 1 than in group 2. The period of blood creatinine subnormalization was significantly shorter in group 1. The differences were statistically significant in all studied parameters (p=0.002-0.003). Conclusion: The allografted kidney function was much better in group 1 than in group 2. Thus, the combination of Eculizumab + Alemtuzumab had a more favorable effect on the function and morphology of allografted kidneys in the immediate and early postoperative periods compared to that of Alemtuzumab + plasmapheresis combination.