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Title: | Historical controlled trial of OKT3 versus basiliximab induction therapy in simultaneous pancreas-renal transplantation. | Authors: | Kerr P.G. ;Chow F.Y.F.;Saunder A. ;Atkins R.C.;Chadban S.J.;Polkinghorne K. | Institution: | (Chow, Polkinghorne, Saunder, Kerr, Atkins, Chadban) Department of Nephrology, Monash Medical Centre, Clayton, Vic., Australia (Chadban) Nephrologist/Transplant Physician, Department of Renal Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia | Issue Date: | 18-Oct-2012 | Copyright year: | 2003 | Publisher: | Blackwell Publishing (550 Swanston Street, Carlton South VIC 3053, Australia) | Place of publication: | Australia | Publication information: | Nephrology. 8 (4) (pp 212-216), 2003. Date of Publication: August 2003. | Abstract: | Simultaneous pancreas - kidney (SPK) transplant recipients are at high immunological risk of rejection. Antibody induction is beneficial but lymphocyte-depleting therapy is associated with a high incidence of side-effects. We performed a historical controlled trial to compare OKT3 versus anti-CD25 antibody (basiliximab) induction therapy with regard to patient, kidney and pancreas survival, as well as to examine for any differences in acute rejection, graft function, and infective complications. Twenty-eight consecutive SPK transplants were performed at the Monash Medical Centre between December 1997 and November 2001. Anti CD3 monoclonal antibody (OKT3) was used prior to March 2000 (n = 12) and basiliximab was used after (n = 16), both in combination with cyclosporin, mycophenolate, and prednisolone. A retrospective comparison of outcomes was performed. At 6 months, patient (100 vs 100%), kidney (91.7 vs 91.7%) and pancreas (75 vs 83.3%) survival were similar in the OKT3 and basiliximab groups, respectively. A minority of subjects in each group remained free from rejection (42% basiliximab vs 25% on OKT3, P = NS). Renal function was superior in the basiliximab group (mean calculated creatinine clearance 79.4 +/- 11.9 vs 54.5 +/- 15.9 mL/min for basiliximab vs OKT3, P < 0.001). The incidence of major opportunistic infection was lower in basiliximab-treated patients (9 vs 50% in the OKT3 group, P = 0.033). Basiliximab was associated with similar 6-month patient, kidney and pancreas survival, superior renal function and less opportunistic infection as compared with OKT3 induction therapy in SPK transplants. Basiliximab is at least as effective and is safer than OKT3 for induction therapy in SPK transplantation. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1046/j.1440-1797.2003.00158.x | PubMed URL: | 15012723 [http://www.ncbi.nlm.nih.gov/pubmed/?term=15012723] | ISSN: | 1320-5358 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/32766 | Type: | Article | Subjects: | *basiliximab/cm [Drug Comparison] creatinine/ec [Endogenous Compound] cyclosporin/cb [Drug Combination] mycophenolic acid/cb [Drug Combination] *OKT 3/cb [Drug Combination] *OKT 3/cm [Drug Comparison] prednisolone/cb [Drug Combination] clinical article acute graft rejection adult article creatinine clearance drug efficacy drug safety female graft infection/co [Complication] graft survival human incidence kidney function *kidney transplantation male *pancreas transplantation priority journal treatment outcome *basiliximab/cb [Drug Combination] *kidney transplantation male *pancreas transplantation priority journal treatment outcome clinical article article human adult graft survival acute graft rejection graft infection / complication creatinine clearance kidney function female drug safety drug efficacy incidence |
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