The outcome of induction therapy with monoclonal antibodies in kidney transplantation among Iranian patients: a prospective study.

INTRODUCTION: The administration of interlukin-2 receptor antagonists for induction therapy has reduced the incidence of acute rejection episodes in kidney transplantation. Although some studies have investigated the efficacy of these monoclonal antibodies, there is little experience among Iranian kidney transplant recipients. MATERIALS AND METHODS: Forty-three patients randomly divided into 2 groups were prospectively followed for 3.4 years. Eighteen patients received 2 doses of basiliximab (group I) and another 25 patients received 5 doses of daclizumab (group II). The posttransplantation complications, last serum creatinine level, as well as graft and patient survival rates were compared to investigate the efficacy of these therapies. RESULTS: Among 43 patients, 11.6% experienced acute rejection episodes: 22.2% in group I and 4% in group II (P > .05). In this study, 4.6% of recipients underwent graft nephrectomy: 11.1% in group I and 4% in group II (P > .05). The mortality rate was 4.6%: 5.5% in group I and 4% in group II (P > .05). The mean serum creatinine level was 1.47 +/- 0.7 mg/dL. Although it was lower in group I, the difference was not significant. The 1-year graft and patient survival rates were 90.6% and 95.3%, respectively, with no significant differences between the groups. DISCUSSION: Although induction therapy with monoclonal antibodies may reduce the incidence of acute rejection episodes, graft and patient survival rates were unchanged compared with conventional therapies. Also, there were no significant differences between the results of induction therapy with basiliximab and daclizumab.

Association of hyperglycemia on allograft function in the early period after renal transplantation.

Hyperglycemia is common following renal transplantation. This study was conducted to evaluate the relationship of perioperative serum glucose levels and acute rejection in 100 nondiabetic patients who underwent renal transplantation. Blood glucose was measured immediately following surgery and every 6 hours during the first 48 hours posttransplant as well as for 1 month to evaluate occurrence of acute rejection episodes (ARE). The rate of ARE was 33%. The mean blood glucose level immediately after surgery in patients with versus without ARE was 249.67 +/- 61.78 and 184.82 +/- 73.35 mg/dL, respectively (P=.000). There was no significant correlation between ARE and donor or recipient age or sex, delayed graft function, type of donor, or treatment. This study suggested a correlation between immediate blood glucose and ARE. In this regard, blood glucose monitoring and control during operation and immediate postoperatively may reduce the acute rejection rate.