Anti-CD25 Antibody (Daclizumab) Maintenance Therapy in Pancreas Transplantation

• Published in: Transplantation proceedings Vol. 42; no. 6; pp. 2003 - 2005
• Main Authors: Kirchner, V.A, Suszynski, T.M, Radosevich, D.M, Humar, A, Dunn, T.B, Hill, M.J, Finger, E.B, Sutherland, D.E.R, Kandaswamy, R
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01-07-2010; Elsevier
• Subjects: Adult; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Biological and medical sciences; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Survival - immunology; Humans; Immunoglobulin G - therapeutic use; Immunosuppressive Agents - therapeutic use; Interleukin-2 Receptor alpha Subunit - immunology; Kidney Transplantation - immunology; Kidney Transplantation - statistics & numerical data; Medical sciences; Middle Aged; Pancreas Transplantation - immunology; Pancreas Transplantation - mortality; Reoperation - statistics & numerical data; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Tissue, organ and graft immunology; Treatment Outcome; Daclizumab; Immunomodulator; Medicine; Anti-CD25; Surgery; Maintenance treatment; Graft; Transplantation; Monoclonal antibody; Immunosuppressive agent; Homotransplantation; Pancreas
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.05.083

Abstract Background Calcineurin inhibitors (CNI) are the basis of contemporary immunosuppression in clinical pancreas transplantation (PT). Nevertheless, CNI toxicities, especially nephrotoxicity, have stimulated the search for CNI-sparing protocols. We performed a retrospective analysis of 25 PT patients with progressive CNI toxicities that were switched to a daclizumab (DAC)–based maintenance regimen. Methods From 2003 to 2007, 25 PT patients with progressive CNI toxicity (predominantly nephrotoxicity) were identified and switched from CNI to monthly DAC maintenance therapy. The DAC group was compared with matched control subjects (1:1) by transplant type and number, age, year of transplant, and duct management. Results and conclusions Results showed improved graft survival rates and decreased immunologic loss rates at 1, 3, and 5 years in the DAC group compared with the control group. There was no difference in patient survival rate between the 2 groups. Analysis demonstrates that DAC maintenance therapy is safe and effective for PT patients experiencing CNI toxicities. A randomized trial to compare DAC- and CNI-based regimens is needed in CNI-intolerant patients, with particular attention to the impact on renal function and patient morbidity (eg, infection rates).