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Low‐dose basiliximab induction therapy in heart transplantation
Author(s) -
Kittipibul Veraprapas,
Tantrachoti Pakpoom,
Ongcharit Pat,
Ariyachaipanich Aekarach,
Siwamogsatham Sarawut,
Sritangsirikul Supaporn,
Thammanatsakul Kanokwan,
Puwanant Sarinya
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13132
Subject(s) - basiliximab , medicine , calcineurin , heart transplantation , dosing , asymptomatic , population , transplantation , surgery , concomitant , tacrolimus , environmental health
We prospectively studied efficacy and safety outcomes of two 10‐mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2‐week assessment post‐transplant, there were no deaths, graft failures, or acute cellular rejections ( ACR s) ISHLT grade ≥ 2R. By the 1‐year assessment post‐transplant, there were 1 (6%) infectious death, no graft failures, 2 (12%) grade 2R ACR s, 6 (35%) asymptomatic cytomegalovirus ( CMV ) infections, and 4 (25%) treated infections. Our study was the first to show that low‐dose basiliximab induction in heart transplant resulted in favorable efficacy and safety outcomes. Additionally, calcineurin inhibitor ( CNI ) initiation in a low‐risk population could be safely delayed using the strategy of modified low‐dose postoperative basiliximab. This strategy also appears to allow subsequent early corticosteroid wean, although with the concomitant maintenance of higher CNI levels and higher dosing of mycophenolate.