INDUCTION THERAPY WITH DACLIZUMAB (ZENAPAX®) IN CARDIAC TRANSPLANTATION

Abstract

76 DACLIZUMAB (Zenapax®) is a new humanized IL-2R- monoclonal antibody indicated for prophylaxis in solid organ transplant rejection. DACLIZUMAB has been shown to reduce acute renal allograft rejection episodes when added to triple and double immunosuppressive protocols. We hope to assess induction prophylaxis, side effects and convenience of administration with this drug in cardiac transplant recipients. Methods: Intravenous DACLIZUMAB 1 mg/kg was given 4-10 hours preoperatively, then every 2 wks for a total of 5 dosages. Early surveillance biopsy was performed at day 5. Rejection episodes were tracked and the results were compared to those of patients on anti-lymphocyte induction therapy (ATGAM or OKT3) who were routinely biopsied at day 10. Results: Rejections by grade on each drug (Table)TableRejection episodes in ≤ 10 weeks on DACLIZUMAB were compared with those of patients on ATGAM or OKT3. Conclusions: 1)No significant side effects of pulmonary cytokine release syndrome or bone marrow/renal toxicities with the usage of DACLIZUMAB were observed. 2) A trend toward earlier hospital discharge post-transplant was noted. 3) A trend of earlier rejection but significantly fewer high grade rejections was observed. Earlier rejection may be attributed to earlier surveillance biopsy performed in the DACLIZUMAB group than in the anti-lymphocyte group. Although the Chi Square test for goodness of fit was significant, these observations were made on a small sample, and large multicenter trials are needed.