Basiliximab Does Not Reduce the Early Rejection Incidence in High-Risk Kidney Recipients Under Tacrolimus-Based Immunosuppression

Abstract

This study sought to evaluate the benefit of addition of basiliximab to tacrolimus-based immunosuppression among high-risk renal transplantations. We retrospectively analyzed the clinical data of the basiliximab induction group (n = 55) and a risk-matched control group (n = 57). Graft survivals rates at 1, 3, and 5 years were 100%, 98.1%, and 91.8%, respectively, for the control and 96.2%, 93.9%, and 76.4%, respectively, for the basiliximab group (P = .083). Patient survivals rates at 1, 3, and 5 years were 98.3%, 98.3%, and 98.3%, respectively, for the control group and 98.2%, 94.2%, and 94.2%, respectively, for the basiliximab group (P = .277). Biopsy-proven acute rejection (AR) within 12 months occurred among 24.6% and 18.2% for the control and induction groups, respectively (P = .492). Serum creatinine levels at 1, 3, 6, and 12 months were 1.23 ± 0.30, 1.38 ± 0.41, 1.47 ± 0.61, and 1.44 ± 0.67 mg/dL, respectively, among the control and 1.24 ± 0.28, 1.40 ± 0.38, 1.40 ± 0.36, and 1.63 ± 1.62 mg/dL, respectively, among the induction group. In conclusion, this study showed that the addition of basiliximab to tacrolimus-based immunosuppression did not further improve the results of high-risk kidney transplantations in terms of reducing AR, prolonging graft survival, or improving renal function.

The development of powerful immunosuppressants has improved the early results of kidney allografts. Anti-CD25 antibody, basiliximab, showed further reduction of acute rejection (AR) among kidney transplantations under cyclosporine (CsA)-based immunosuppression. Tacrolimus (TAC), another powerful immunosuppressant, has been substituted for CsA.1 A combination of potent immunosuppressants usually reduces AR and enhances graft survival but can be associated with increased toxic side effect infection, or malignancy rates. We retrospectively analyzed our experience to see whether the addition of basiliximab to TAC-based immunosuppression further improved high-risk renal transplantations.