Journal ArticleDOI
Basiliximab versus rabbit anti-thymocyte globulin for induction therapy in patients after heart transplantation.
TLDR
Rabbit anti-thymocyte globulin is more effective than basiliximab for prevention of rejection episodes after heart transplantation and both induction agents provide similar safety profile.Abstract:
Background The use of basiliximab or rabbit anti-thymocyte globulin (RATG) for induction therapy has significantly reduced the incidence of acute rejection episodes post-transplantation. The purpose of this study was to compare the safety and efficacy of basiliximab vs RATG in a population of adult heart transplant recipients. Methods We retrospective analyzed the safety and efficacy of basiliximab compared with RATG among 48 adult heart transplant recipients at our center. Twenty-five patients received basiliximab (20 mg on days 0 and 4 after heart transplantation), and 23 patients received RATG (1.5 mg/kg for 3 days). A standard triple-drug immunosuppression regimen was administered to all patients. Results The average biopsy score (ABS) at 1 month was 0.79 ± 0.18 in the Basiliximab Group vs 0.47 ± 0.2 in the RATG group ( p = 0.023) and at 3 months was 0.75 ± 0.24 in the Basiliximab Group vs 0.46 ± 0.12 in the RATG Group ( p = 0.032). At 6 months after transplantation, the difference between groups was not statistically significant (0.97 ± 0.23 vs 0.58 ± 0.17, p = .14). At 12 months the ABS was 0.85 ± 0.4 in the Basiliximab Group vs 0.63 ± 0.15 in the RATG Group ( p = 0.12), and the number of episodes of infection was similar in both groups (19 vs 26; p = 0.16). There was no correlation between cumulative cyclosporine doses and rejection. Creatinine clearance levels were not statistically different between groups at baseline and up to 12 months after heart transplantation. Three patients died in the Basiliximab Group, and 2 patients died in the RATG Group. Conclusions Rabbit anti-thymocyte globulin is more effective than basiliximab for prevention of rejection episodes after heart transplantation. Both induction agents provide similar safety profile.read more
Citations
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Journal ArticleDOI
The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients
Maria Rosa Costanzo,Anne I. Dipchand,Randall C. Starling,Allen S. Anderson,Michael Chan,Shashank Desai,Savitri Fedson,Patrick W. Fisher,Gonzalo Gonzales-Stawinski,Luigi Martinelli,David C. McGiffin,Jon Smith,David O. Taylor,Bruno Meiser,Steven A. Webber,David A. Baran,Michael P. Carboni,Thomas J. Dengler,David L. Feldman,Maria Frigerio,Abdallah G. Kfoury,Daniel Kim,Jon A. Kobashigawa,Michael A. Shullo,Josef Stehlik,Jeffrey J. Teuteberg,Patricia A. Uber,Andreas Zuckermann,Sharon A. Hunt,Michael Burch,Geetha Bhat,Charles E. Canter,Richard E. Chinnock,Marisa G. Crespo-Leiro,Reynolds M. Delgado,Fabienne Dobbels,Kathleen L. Grady,W. Kao,Jaqueline Lamour,Gareth Parry,Jignesh Patel,Daniela Pini,Jeffrey A. Towbin,Gene Wolfel,Diego H. Delgado,Howard J. Eisen,Lee R. Goldberg,Jeff Hosenpud,Maryl R. Johnson,Anne Keogh,Clive Lewis,John B. O'Connell,Joseph G. Rogers,Heather J. Ross,Stuart D. Russell,Johan Vanhaecke,Amanda W. Rowe +56 more
TL;DR: Institutional Affiliations Chair Costanzo MR: Midwest Heart Foundation, Lombard Illinois, USA Task Force 1 Dipchand A: Hospital for Sick Children, Toronto Ontario, Canada; Starling R: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Starlings R: University of Chicago, Chicago, Illinois,USA; Chan M: university of Alberta, Edmonton, Alberta, Canada ; Desai S: Inova Fairfax Hospital, Fairfax, Virginia, USA.
Journal ArticleDOI
Lower risk of infectious deaths in cardiac transplant patients receiving basiliximab versus anti-thymocyte globulin as induction therapy.
Marie Françoise Mattei,Michel Redonnet,Iradj Gandjbakhch,Annick Mouly Bandini,Allain Billes,Eric Epailly,Romain Guillemain,Bernard Lelong,Annie Pol,M. Treilhaud,Emmanuelle Vermes,Richard Dorent,Djamila Lemay,Anne Sandrine Blanc,Pascale Boissonnat +14 more
TL;DR: Basiliximab offers improved tolerability with similar efficacy compared with current polyclonal antibody induction therapy in de novo heart transplant patients, and this 6-month, prospective, randomized, multicenter, open-label study examined whether basiliximrab offers a tolerability benefit compared with anti-thymocyte globulin.
Journal ArticleDOI
Immunosuppressive therapies after heart transplantation — The balance between under- and over-immunosuppression
Carl Söderlund,Göran Rådegran +1 more
TL;DR: The purpose of the present review was to summarize some major points regarding immunosuppressive therapies after HT and the balance between under- and over-immunosuppression.
Journal ArticleDOI
Lung transplant infection
TL;DR: The common infections that develop in the lung transplant recipient, including the general risk factors for infection in this population, and the most frequent bacterial, viral, fungal and other less frequent opportunistic infections are reviewed.
Journal ArticleDOI
Basiliximab and rabbit anti-thymocyte globulin for prophylaxis of acute rejection after heart transplantation: a non-inferiority trial.
Michel Carrier,Marie-Hélène Leblanc,Louis P. Perrault,Michel White,Daniel Doyle,Danielle Beaudoin,Marie-Claude Guertin +6 more
TL;DR: Non-inferiority of basiliximab treatment for prophylaxis of acute rejection after heart transplantation could not be shown, and RATG administration is associated with a higher rate of asymptomatic cytomegalovirus viral load detection in the plasma.
References
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Journal ArticleDOI
Immunoprophylaxis with basiliximab compared with antithymocyte globulin in renal transplant patients receiving MMF-containing triple therapy.
Yvon Lebranchu,Frank Bridoux,Matthias Büchler,Yannick Le Meur,Isabelle Etienne,Olivier Toupance,Bruno Hurault de Ligny,Guy Touchard,Bruno Moulin,Patrick Le Pogamp,O Reigneau,Michel Guignard,Gérard Rifle +12 more
TL;DR: Both strategies give excellent results, despite the differences in patterns, in nonhyperimmunized patients receiving their first cadaveric renal allograft in adult kidney transplant patients.
Journal ArticleDOI
A prospective, randomized, clinical trial of intraoperative versus postoperative Thymoglobulin in adult cadaveric renal transplant recipients.
William C. Goggins,Manuel Pascual,John A. Powelson,Colm C. Magee,Nina Tolkoff-Rubin,Mary Lin Farrell,Dicken S.C. Ko,Winfred W. Williams,Anil Chandraker,Francis L. Delmonico,Hugh Auchincloss,A. Benedict Cosimi +11 more
TL;DR: It is indicated that intraoperative Thymoglobulin administration, in adult cadaveric renal transplant recipients, is associated with a significant decrease in DGF, better early allograft function in the first month posttrans transplant, and a decreased posttransplant hospital length of stay.
Journal ArticleDOI
Steroid-free liver transplantation using rabbit antithymocyte globulin and early tacrolimus monotherapy.
TL;DR: Steroid-free liver transplantation using RATG and early tacrolimus monotherapy effectively reduces immunosuppression-related complications with excellent survival and there was a trend toward decreased severity of hepatitis C virus in the R ATG group.
Journal ArticleDOI
A prospective study of rapid corticosteroid elimination in simultaneous pancreas-kidney transplantation: Comparison of two maintenance immunosuppression protocols: Tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus
Dixon B. Kaufman,Joseph R. Leventhal,Alan J. Koffron,Lorenzo Gallon,Michele Parker,Jonathan P. Fryer,Michael Abecassis,Frank P. Stuart +7 more
TL;DR: It is concluded that chronic corticosteroid exposure is not required in SPK transplant recipients receiving antithymocyte globulin induction and maintenance immuno-suppression consisting of either tacrolimus and mycophenolate mofetil or tacro Limus and sirolimus.
Journal ArticleDOI
Five-year follow up of thymoglobulin versus ATGAM induction in adult renal transplantation.
Karen L. Hardinger,Mark A. Schnitzler,Brent W. Miller,Jeffrey A. Lowell,Surendra Shenoy,Matthew J. Koch,Decha Enkvetchakul,Connie Ceriotti,Daniel C. Brennan +8 more
TL;DR: Thymoglobulin was associated with higher event-free survival, graft survival, and freedom from rejection without increased PTLD or CMV disease at 5 years compared with Atgam, and the prolonged and profound lymphopenia may contribute to the long-term results associated with ThymoglOBulin.
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Lower risk of infectious deaths in cardiac transplant patients receiving basiliximab versus anti-thymocyte globulin as induction therapy.
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The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients
Maria Rosa Costanzo,Anne I. Dipchand,Randall C. Starling,Allen S. Anderson,Michael Chan,Shashank Desai,Savitri Fedson,Patrick W. Fisher,Gonzalo Gonzales-Stawinski,Luigi Martinelli,David C. McGiffin,Jon Smith,David O. Taylor,Bruno Meiser,Steven A. Webber,David A. Baran,Michael P. Carboni,Thomas J. Dengler,David L. Feldman,Maria Frigerio,Abdallah G. Kfoury,Daniel Kim,Jon A. Kobashigawa,Michael A. Shullo,Josef Stehlik,Jeffrey J. Teuteberg,Patricia A. Uber,Andreas Zuckermann,Sharon A. Hunt,Michael Burch,Geetha Bhat,Charles E. Canter,Richard E. Chinnock,Marisa G. Crespo-Leiro,Reynolds M. Delgado,Fabienne Dobbels,Kathleen L. Grady,W. Kao,Jaqueline Lamour,Gareth Parry,Jignesh Patel,Daniela Pini,Jeffrey A. Towbin,Gene Wolfel,Diego H. Delgado,Howard J. Eisen,Lee R. Goldberg,Jeff Hosenpud,Maryl R. Johnson,Anne Keogh,Clive Lewis,John B. O'Connell,Joseph G. Rogers,Heather J. Ross,Stuart D. Russell,Johan Vanhaecke,Amanda W. Rowe +56 more