بررسي ميزان تأثير افزودن دوز پايين داکليزوماب به پروتکل استاندارد در کاهش پس زدن پيوند در بيماران گيرنده کليه

Abstract

Introduction: Transplantation of the kidney is the choice treatment of advanced chronic renal failure. One of the most important therapeutic problems in these patients is the prevention of acute graft rejection. The purpose of this study was to investigate the efficiency of low dose Daclizumab for prevention of acute kidney graft rejection in living donor recipients . Methods: This clinical trial study was performed on 120 living donor kidney recipients who were admitted to kidney transplant ward of Kerman Afzalipour hospital. These patients were randomly assigned into two intervention and control groups. The intervention group received Cyclosporine, Mycophenolate mofetil and Prednisolone plus Daclizumab at a dose of 1mg/kg before transplantation and then two weeks later. Other 60 patients received all above drugs except Daclizumab. All patients were followed up for at least 6 months for acute rejection, rejection episode time and the rate of infectious complications. Results: The rate of acute rejection was significantly lower in the intervention group compared with the control group (6.7% vs. 18.3%; P=0.048). The six-month graft survival rate in the intervention group was 95% and in the control group it was 85% (P=0.029). There was a significant difference in 6-month graft survival between the women of the intervention and control groups (97% vs. 74%; P=0.02) but no significant difference was observed between the men in the two groups (94% and 92%). The incidence of serious infection was similar in the two groups Conclusion: The use of induction therapy with two doses of Daclizumab in living donor kidney recipients reduces the incidents of acute rejection with improving graft survival especially in women and does not result in more infectious complications