TY - JOUR
T1 - Induction therapy with interleukin-2 receptor antagonist after intestinal transplantation is associated with reduced acute cellular rejection and improved renal function
AU - Farmer, D. G.
AU - McDiarmid, S. V.
AU - Edelstein, S.
AU - Renz, J. F.
AU - Hisatake, G.
AU - Cortina, G.
AU - Fondevila, C.
AU - Correa, M.
AU - Rhodes, S.
AU - Zafar, A.
AU - Chavez, Y.
AU - Yersiz, H.
AU - Busuttil, R. W.
PY - 2004/3
Y1 - 2004/3
N2 - Purpose To determine the effectiveness of induction immunotherapy with interleukin-2 receptor antagonists (IL2RA) after intestinal transplantation (IT). Methods A single-center, retrospective study was undertaken of all patients undergoing IT using existing medical records and database. Immunotherapy was either triple (standard maintenance triple therapy [SMTT]) or IL2RA [induction IL2RA plus SMTTx] or OKT3 [induction antilymphocyte preparations plus SMTTx]). Data was collected for the first 175 postoperative days. Outcomes included pretransplant renal function, posttransplant serum creatinine normalized to age (nl-sCR), rejection (ACR), and survival. Standard statistical analysis was undertaken. Results There were no significant differences in the groups: triple (n = 10, median age 3.5 years, cGFR 106 ± 44 mL/min), IL2RA (n = 13, median age 3.2 years, cGFR 101 ± 61 mL/min), OKT3 (n = 4, median age 7.7 years, cGFR 104 ± 27 mL/min). nl-sCR was significantly (P < .01) lower in IL2RA at most postoperative weeks. IL2RA had significantly fewer rejection and infectious episodes than the other two groups. Three-year patient survival was 92% in IL2RA versus 50% triple and OKT3. Conclusions IL2RA immunotherapy after IT is associated with a lower incidence of renal dysfunction as compared with historical controls. Furthermore, IL2RA therapy resulted in a lower incidence of rejection and improved survival. IL2RA should be considered in select patients undergoing IT.
AB - Purpose To determine the effectiveness of induction immunotherapy with interleukin-2 receptor antagonists (IL2RA) after intestinal transplantation (IT). Methods A single-center, retrospective study was undertaken of all patients undergoing IT using existing medical records and database. Immunotherapy was either triple (standard maintenance triple therapy [SMTT]) or IL2RA [induction IL2RA plus SMTTx] or OKT3 [induction antilymphocyte preparations plus SMTTx]). Data was collected for the first 175 postoperative days. Outcomes included pretransplant renal function, posttransplant serum creatinine normalized to age (nl-sCR), rejection (ACR), and survival. Standard statistical analysis was undertaken. Results There were no significant differences in the groups: triple (n = 10, median age 3.5 years, cGFR 106 ± 44 mL/min), IL2RA (n = 13, median age 3.2 years, cGFR 101 ± 61 mL/min), OKT3 (n = 4, median age 7.7 years, cGFR 104 ± 27 mL/min). nl-sCR was significantly (P < .01) lower in IL2RA at most postoperative weeks. IL2RA had significantly fewer rejection and infectious episodes than the other two groups. Three-year patient survival was 92% in IL2RA versus 50% triple and OKT3. Conclusions IL2RA immunotherapy after IT is associated with a lower incidence of renal dysfunction as compared with historical controls. Furthermore, IL2RA therapy resulted in a lower incidence of rejection and improved survival. IL2RA should be considered in select patients undergoing IT.
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U2 - 10.1016/j.transproceed.2004.01.099
DO - 10.1016/j.transproceed.2004.01.099
M3 - Article
C2 - 15050149
AN - SCOPUS:12144290019
VL - 36
SP - 331
EP - 332
JO - Transplantation Proceedings
JF - Transplantation Proceedings
SN - 0041-1345
IS - 2
ER -