Efficacy and tolerability of interleukin‐2 receptor blockade with basiliximab in pediatric renal transplant recipients

Publisher Website
Google Scholar
Abstract
‘Abstract: Rejection remains a major threat in pediatric renal transplantation (Tx), causing graft failure and increased exposure to drugs. The new chimeric antibody, basiliximab, directed against the α‐chain of the interleukin‐2 receptor (IL‐2R), has been shown to be effective in preventing rejection episodes in adult renal transplant recipients. In our single‐center experience from Essen, Germany, we evaluated prospectively the efficacy and tolerability of basiliximab, in combination with cyclosporin A (CsA) and prednisone, in 38 unselected pediatric patients. Mean patient age at Tx was 10.1 yr. Twenty‐eight children received a cadaveric organ and 10 children received living‐related donor grafts. The 1‐yr patient survival rate was 100% and the 1‐yr graft survival rate was 95% (36/38 patients). No graft was lost as a result of immunological factors, and single rejection episodes were observed in eight patients (21%). Two of these rejections were steroid‐resistant and responded to tacrolimus rescue therapy. The rate of infections was not enhanced; overt cytomegalovirus (CMV) disease was observed in two patients only. Malignancies have not been seen to date. The blockade of the α‐chain of the IL‐2R lasted for up to 6 weeks. We conclude that the addition of basiliximab to standard immunosuppression in pediatric renal transplant recipients is well tolerated and results in a low incidence of rejection. The simple mode of application and the lack of side‐effects make basiliximab an especially useful adjunct in pediatric patients.