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ATG-Fresenius or daclizumab induction therapy in immunologically high risk kidney recipients : a prospective randomized pilot trial
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 1196950
Author(s) Kim, Min Jeong; Tsinalis, Dimitrios; Franz, Stefan; Binet, Isabelle; Gürke, Lorenz; Mihatsch, Michael J; Steiger, Jürg; Thiel, Gilbert; Dickenmann, Michael
Author(s) at UniBasel Gürke, Lorenz
Dickenmann, Michael Jan
Mihatsch, Michael J.
Steiger, Jürg
Year 2008
Title ATG-Fresenius or daclizumab induction therapy in immunologically high risk kidney recipients : a prospective randomized pilot trial
Journal Annals of Transplantation
Volume 13
Number 4
Pages / Article-Number 21-7
Keywords anti-T-lymphocyte immunoglobulin, anti-IL-2-R antibody, sensitized renal transplant recipients, induction therapy
Abstract Background: Despite all the advantages in the immunosuppressive therapy, kidney transplantation in immunologically high risk patients remains a challenge. Ideally, an induction therapy should provide maximal graft protection, while adverse events rate and costs remain as low as possible.
Material ; Methods: Immunologically high risk kidney recipients with CDC-PRA 25% within the last 3 years, a positive B-cell CDC-crossmatch or graft loss due to rejection within 3 years following a prior transplantation, were randomized 1:1 to receive ATG-Fresenius (ATG-F) (9 mg/kg day 0; 3 mg/kg day 1-4) or Daclizumab therapy (1 mg/kg day 0, 14, 28, 42, 56) in a pilot study. Additional immunosuppression consisted of cyclosporine, mycophenolate mofetil, and steroids. 11 patients were included in each group.
Results: The patient (90% in ATG-F; 100% in Daclizumab) and graft survival (censored for death) (100% in ATG-F; 90% in Daclizumab) and the mean creatinine concentration at 24 months (139+/-68mol/l in ATG-F; 176+/-103mol/l in Daclizumab) were similar in both groups. More severe graft rejections (3 vascular rejections in Daclizumab) and adverse events (5.3/patient in ATG-F; 6.7/patient in Daclizumab) were observed in the Daclizumab group. The costs for hospitalization/ day within 24 months were lower in ATG-F (2.32+/-3.51 USD vs. 12.25+/-9.75 USD; p=0.02) resulting in an average cost-difference of more than 10'435 USD /patient.
Conclusions: In this pilot trial, both treatments were comparably successful regarding graft and patient outcome.
Publisher MEDICAL SCIENCE INTERNATIONAL SP Z O O
ISSN/ISBN 1425-9524
edoc-URL http://edoc.unibas.ch/dok/A6007110
Full Text on edoc No
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/19034219
ISI-Number WOS:000262026700003
Document type (ISI) Journal Article, Randomized Controlled Trial
 
   

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