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Can daclizumab reduce acute rejection and improve long‐term renal function in tacrolimus‐based primary renal transplant recipients?
Author(s) -
CHEUNG CHI YUEN,
LIU YAN LUN,
WONG KIM MING,
CHAN HOI WONG,
CHAN YIU HAN,
WONG HO SING,
CHAK WAI LEUNG,
CHOI KOON SHING,
CHAU KA FOON,
SHEK CHI CHUNG,
LI CHUN SANG
Publication year - 2008
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2007.00911.x
Subject(s) - daclizumab , medicine , tacrolimus , transplantation , urology , renal function , azathioprine , immunosuppression , kidney transplantation , malignancy , creatinine , surgery , disease
SUMMARY: Aims: To evaluate the efficacy and safety of a tacrolimus‐based immunosuppressive regimen with and without induction therapy using daclizumab in first cadaveric renal transplant recipients. Methods: Since January 2001, we studied the effect of daclizumab in a non‐randomized and prospective study of 36 sequential first cadaveric renal transplant recipients. They were compared with a historical control group of 21 sequential first cadaveric renal transplant recipients without induction therapy. All patients received tacrolimus, azathioprine and corticosteroids as concomitant immunosuppressive therapy. Daclizumab was given at 1 mg/kg infusion 2 h before transplantation and then every 14 days for four more doses. Outcomes measured included incidence of acute rejection, patient survival, graft survival, annualized change in creatinine clearance (CrCl), cardiovascular risk profile, infection and malignancy. Results: Fewer biopsy proven acute rejections were observed in the induction treatment group: 11.1% (4/36) versus 19% (4/21) but the rejection free survival was similar ( P = 0.37). The patient survival and graft survival were comparable. The renal function was similar in both groups. There were also no significant difference in infection, malignancy and cardiovascular risk profile in both groups. Conclusion: Adding daclizumab to a tacrolimus‐based therapy is safe but cannot further improve clinical efficacy.