ABSTRACT
Acute rejection remains a major problem in renal transplantation and represents one of the most important causes of chronic allograft dysfunction and late graft loss. Daclizumab is a genetically engineered human IgGl monoclonal antibody that binds specifically to the a chain of the interleukin-2 receptor, and may thus reduce the risk of reection after renal transplantation. The aim of this study was to examine the effect of daclizumab induction therapy combined with a triple immunosuppressive protocol including prednisolone, cyclosporine microemulsion [CsA], and mycophenolate mofetil [MMF], in reducing the incidence of acute rejection in recipients of living unrelated donor kidneys. In this historical cohort study, 43 adult recipients of their first kidney allograft received daclizumab [three l mg/kg doses administered every 2 weeks] with triple immunosuppressive therapy [steroids, CsA, and MMF]. This group was compared to 43 first-time graft recipients who received maintenance triple immunosuppressive therapy comprising steroids, CsA, and MMF. The end point was the incidence of biopsy-confirmed acute rejection within 6 months after transplantation. Results: At 6 months, 5 [11.6%] of the patients in the daclizumab group had biopsy-proven rejections, as compared to 14 [32.5%] in the control group [P = 0.017]. The sex and the age of recipients had no impact on the incidence of acute rejection episodes in the two groups. Adding interleukin-2 receptor antibody [daclizumab] to maintenance triple immunosuppressive therapy [prednisolone, CsA, and MMF] reduces the incidence of acute rejection episodes at 6 months in first-time transplant recipients of living unrelated donor