Journal ArticleDOI
Induction therapy with basiliximab allows delayed initiation of cyclosporine and preserves renal function after cardiac transplantation.
Paul B. Rosenberg,Paul B. Rosenberg,Ank E. Vriesendorp,Mark H. Drazner,Mark H. Drazner,Daniel L. Dries,Patricia A. Kaiser,Linda S. Hynan,J. Michael DiMaio,J. Michael DiMaio,Dan M. Meyer,Dan M. Meyer,W. Steves Ring,W. Steves Ring,Clyde W. Yancy,Clyde W. Yancy +15 more
TLDR
Basiximab induction therapy allows delayed initiation of cyclosporine after cardiac transplantation without an increase in rejection and reduces the risk of post-operative renal dysfunction.Abstract:
Background Cyclosporine (CsA) is frequently initiated as induction therapy in patients undergoing orthotopic heart transplantation, but our experience has identified a significant rate of post-operative renal dysfunction. We therefore devised a renal-sparing cyclosporine-free induction regimen consisting of the early administration basiliximab, an interleukin-2 receptor monoclonal antibody, followed by the late initiation of cyclosporine on post-operative Day 4. Methods Between September 1998 and December 1999, we treated 25 patients at risk for post-operative renal dysfunction (high-risk basiliximab group) with the new induction regimen and another 33 patients not at risk (low-risk CsA group) for renal dysfunction with our standard cyclosporine protocol. We identified a historical control group (1996 through 1998) of 32 patients at risk for renal dysfunction (high-risk CsA group) who had received our standard cyclosporine protocol. Results The increase in serum creatinine levels after transplantation was less in the high-risk basiliximab group (−0.1 ± 0.7) than in the high-risk CsA group (0.5 ± 1.0, p p = .13). Conclusion Basiliximab induction therapy allows delayed initiation of cyclosporine after cardiac transplantation without an increase in rejection and reduces the risk of post-operative renal dysfunction.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
Calcineurin‐inhibitor minimization protocols in heart transplantation
Stefan Farkas,Andreas A. Schnitzbauer,Gabi I. Kirchner,Aiman Obed,Bernhard Banas,Hans J. Schlitt +5 more
TL;DR: An individualized, tailor‐made immunosuppressive regime, with a special focus on renal function is recommended, to prevent chronic renal dysfunction in patients prone to or with acute renal failure.
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
Present Status and Future Perspectives of Heart Transplantation
TL;DR: Although mechanical circulatory support technology is improving, heart transplantation remains the preferred treatment for many patients because of major complications, such as stroke, bleeding and infection, andBecause of limited quality of life related to the driveline and the need for battery change, significant efforts have been made to maximize the number of heart transplants and to ensure good outcomes.
References
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Journal ArticleDOI
Chronic renal failure after transplantation of a nonrenal organ.
Akinlolu O. Ojo,Philip J. Held,Friedrich K. Port,Robert A. Wolfe,Alan B. Leichtman,Eric W. Young,J.A Arndorfer,Laura L. Christensen,Robert M. Merion +8 more
TL;DR: The five-year risk of chronic renal failure after transplantation of a nonrenal organ ranges from 7 to 21 percent, depending on the type of organ transplanted, and is associated with an increase by a factor of more than four in the risk of death.
Journal ArticleDOI
Cyclosporine-associated chronic nephropathy
TL;DR: It is concluded that long-term cyclosporine therapy may lead to irreversible and potentially progressive nephropathy and should be used with restraint and caution until ways are found to mitigate its nephrotoxicity.
Journal ArticleDOI
Randomized versus historical controls for clinical trials
TL;DR: The data suggest that biases in patient selection may irretrievably weight the outcome of HCts in favor of new therapies, and that RCTs may miss clinically important benefits because of inadequate attention to sample size.
Journal ArticleDOI
Randomised trial of basiliximab versus placebo for control of acute cellular rejection in renal allograft recipients
TL;DR: Prophylaxis with 40 mg basiliximab reduces the incidence of acute rejection episodes significantly, with no clinically relevant safety or tolerability concerns.
Journal ArticleDOI
Cyclosporin: an updated review of the pharmacokinetic properties, clinical efficacy and tolerability of a microemulsion-based formulation (neoral)1 in organ transplantation.
TL;DR: The introduction of cyclosporin microemulsion has consolidated the place of the drug as a mainstay of therapy in all types of solid organ transplantation and savings in direct healthcare costs in kidney or liver transplantation are shown, although studies incorporating indirect costs or expressing costs in terms of therapeutic outcomes are currently unavailable.
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