Abstract
O215 Induction with lympholytic or lymphocyte modulating antibodies is used in kidney transplant recipients to reduce acute rejections(AR) in the first 6 months, to delay initiation of calcineurin inhibitors(CNI), and to maintain low dose steroids or for steroid avoidance. This study was carried out to test the efficacy of induction with non lymphocyte depleting, anti CD 25 antibody, basiliximab to reduce AR in the first 6 months and to maintain steroid free maintenance immunosuppression in primary kidney transplant recipients. 300 primary kidney transplant recipients recipients transplanted between December 1998 and November 2003 were analyzed.150 were in steroid free immunosuppression(group 1) and 150 recipients were maintained on long term steroid therapy(group 2). The 2 groups were comparable for recipent and donor demography. Maintenance immunosuppression was CNI and mycophenolate mofetil(MMF) or sirolimus(SLR) in group1 and CNI, MMF or SLR and prednisone in group 2. In group 1, steroids were discontinued between days 2 to 7 and in group 2 steroids were continued for the life of the graft. The 2 groups were compared for delayed graft function(DGF), AR, serum creatinine (SC) and creatinine clearance(CCl) at 6 months and 1 year patient and graft survival. AR were diagnosed by biopsy and treated with pulse doses of methylprednisolone. In group 1 all recipients including those with AR remained on steroid free therapy. Table shows the Donor source, DGF, AR, SC and C.Cl at 6 months and 1 year patient and graft survival.[table]1 year patient survival was 96% and 93% and graft survival was 91% and 90% in groups 1 and 2 respectively. This data indicates that basiliximab induction and CNI based steroid free immunosuppression provide equivalent graft function and graft survival with low incidence of acute rejections comparable to recipients treated with similar immunosuppression+steroid therapy. We conclude that basiliximab decreases AR and provides comparable outcome in primary kidney transplant recipients in steroid free CNI based immunosuppression to those treated with chronic steroid therapy.Figure
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