Cyclosporine-Sparing Effect of Basiliximab in Renal Transplant Recipients With Mycophenolate Mofetil

Abstract

Basiliximab added to a maintenance regimen consisting of cyclosporine microemulsion and mycophenolate mofetil was studied for its effectiveness in allowing early steroid withdrawal in renal transplantion. Furthermore, the cyclosporine-sparing effects between groups with and without basiliximab induction therapy were compared. Patients Between September 2001 and June 2003, 90 patients underwent renal transplants with cyclosporine-based immunosuppression, namely, cyclosporine, mycophenolate mofetil, and methylprednisolone, (group 1; n = 25). During the latter half of the study basiliximab was administered during the induction phase (group 2; n = 65). In group 2, steroids were completely withdrawn on postoperative day 14 in 57 patients. Results The incidence of acute rejection was significantly higher among group 1 patients ( P = .005). The incidence of steroid-resistant rejection in group 1 patients was significantly higher ( P = .025). At each time point cyclosporine levels in group 1 patients were significantly higher ( P < .01). The incidence of infection was comparable between the groups. Patient and graft survival rates in group 1 were 100% and 100%; in group 2, they were 99% and 99%, respectively. In group 2, steroids were discontinued in 57 patients with permanent withdrawal achieved in 32 patients (56%). Conclusion The use of basiliximab, together with mycophenolate mofetil allowed for a significant reduction in the cyclosporine dose without increasing the risk of acute rejection. Although further follow-up is necessary to confirm the effect, this regimen may attenuate cyclosporine nephrotoxicity thereby affecting the long-term outcomes of renal transplantation.