Low‐dose basiliximab induction therapy in heart transplantation |
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| Authors: | Veraprapas Kittipibul Pakpoom Tantrachoti Pat Ongcharit Aekarach Ariyachaipanich Sarawut Siwamogsatham Supaporn Sritangsirikul Kanokwan Thammanatsakul Sarinya Puwanant |
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| Affiliation: | 1. Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;2. Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand;3. Excellent Center of Organ Transplantation, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand |
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| Abstract: | ![]()
We prospectively studied efficacy and safety outcomes of two 10‐mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2‐week assessment post‐transplant, there were no deaths, graft failures, or acute cellular rejections (ACRs) ISHLT grade ≥ 2R. By the 1‐year assessment post‐transplant, there were 1 (6%) infectious death, no graft failures, 2 (12%) grade 2R ACRs, 6 (35%) asymptomatic cytomegalovirus (CMV) infections, and 4 (25%) treated infections. Our study was the first to show that low‐dose basiliximab induction in heart transplant resulted in favorable efficacy and safety outcomes. Additionally, calcineurin inhibitor (CNI) initiation in a low‐risk population could be safely delayed using the strategy of modified low‐dose postoperative basiliximab. This strategy also appears to allow subsequent early corticosteroid wean, although with the concomitant maintenance of higher CNI levels and higher dosing of mycophenolate. |
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| Keywords: | fusion proteins and monoclonal antibodies: basiliximab/daclizumab heart (allograft) function/dysfunction immunosuppressant rejection |
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