[Efficacy of IL-2 receptor blockers in live donor renal transplantation]

ABSTRACT

In the early post-transplantation period, acute rejection is the major cause of graft failure. It is also one of the most important predictors for long-term graft survival following renal transplantation. This study was aimed to compare the rate of acute rejection [AR] between patients receiving and those not receiving IL-2 Receptor Blockers for induction therapy. Ninety four patients undergoing renal transplantation from living donor were randomized into a prospective controlled trial. The patients were divided into two groups D+ including 47 cases [26 men, 21 women with the mean age of 27.8 +/- 15.2 years] received Prednisolone, Cyclosporine, Mycophenolate Mofetil, plus Daclizumab and D- including 47 cases [28 men, 19 women, mean age 28.4 +/- 12.8 years] received all above drugs except for Daclizumab. They were matched considering the age of recipients and donors, recipient-donor relationship, underlying diseases and panel reactivity test status. Individual and laboratory data were recorded in the questionnaire. Data was analyzed using qualitive statistics and frequency distribution tables. All patients completed the 6 month study. The acute tolerability for Daclizumab injection was good without any evidence of cytokine-release syndrome. D+ patients had less AR as compared with D-treated patients [17.02% vs. 8.51%]. Graft survival at 6 months was higher with Daclizumab [100%] as compared with no induction [97.4%]. Serious infection was seen in five cases [10.41%] in D+ group and 4 cases [8.33%] in control group. Patient death or malignancies did not occur in any group. Our study demonstrates that induction with Daclizumab results in reduction of early renal allograft rejection. The therapy with anti-IL-2R antibody is simple and is well tolerated