Faculty Collaboration Database

Use of anti-CD25 monoclonal antibody in combination with rapamycin to eliminate cyclosporine treatment during the induction phase of immunosuppression. Transplantation 1999 Sep 15;68(5):701-4

Date

10/03/1999

Pubmed ID

10507492

DOI

10.1097/00007890-199909150-00018

Scopus ID

2-s2.0-0033567982 (requires institutional sign-in at Scopus site)   70 Citations

Abstract

BACKGROUND: Cyclosporine and tacrolimus are associated with drug-induced renal dysfunction that may exacerbate recovery from ischemic injuries during the first month posttransplant. We sought to use anti-CD25 (anti-interleukin-2 receptor) monoclonal antibodies in combination with sirolimus (rapamycin) to avoid cyclosporine therapy during the early postoperative period in six renal transplant recipients deemed to be at high risk for delayed graft function.

METHODS: Six consecutive patients deemed to be at high risk for delayed graft function were treated with rapamycin (2-12 mg/day), anti-CD25 monoclonal antibodies, and steroids, withholding inception of cyclosporine therapy until the serum creatinine fell below 3.0 mg/dl.

RESULTS: During the first 2 months posttransplant, none of the patients displayed clinical or histopathological evidence of acute allograft rejection episodes, cytokine release syndrome, or hypersensitivity reactions. None of the patients received even empiric bolus or high-dose steroid therapy for a presumed rejection episode. All patients recovered renal graft function within 8 weeks posttransplant. To date all patients have stable renal graft function. Five patients have serum creatinine levels between 0.8 to 1.3 mg/dl at 6 months and the other patient has a serum creatinine level of 1.7 mg/dl at present follow-up of 2 months posttransplant.

CONCLUSION: During the early posttransplant period anti-CD25 monoclonal antibodies combined with rapamycin and steroids offer a promising baseline therapy to avoid cyclosporine exposure and facilitate recovery from ischemic/reperfusion injuries.

Author List

Hong JC, Kahan BD

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antibodies, Monoclonal
Cyclosporine
Drug Therapy, Combination
Humans
Immunosuppressive Agents
Kidney
Kidney Transplantation
Male
Middle Aged
Receptors, Interleukin-2
Sirolimus
Time Factors
Treatment Outcome