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1: Transpl Int. 2004 Sep;17(8):395-401. Epub 2004 Sep 8.Click here to read Links

Interleukin-2 receptor antagonists and aggressive steroid minimization strategies for kidney transplant patients.

Vincenti F.

Kidney Transplant Service, University of California-San Francisco, 505 Parnassus, Box 0116, San Francisco, CA 94143, USA. VincentiF@surgery.ucsf.edu

Steroid withdrawal during the first week after transplantation surgery, or complete avoidance of steroids, offers potential benefits. The interleukin-2 (IL-2) receptor antibodies, basiliximab and daclizumab, can enable aggressive steroid minimization protocols that are efficacious while reducing toxicity. A multicenter, randomized trial of kidney transplant recipients has shown the incidence of biopsy-proven acute rejection with basiliximab, cyclosporine and mycophenolate mofetil with steroids withdrawn at day 5 to be similar to a conventional triple-therapy regimen. A single perioperative dose of corticosteroids with an IL-2 receptor antagonist also seems as efficacious as standard steroid therapy. Corticosteroid-minimization with IL-2 receptor antagonists has also been investigated with sirolimus-containing regimens and has shown excellent outcomes. Experience with complete steroid avoidance, using an IL-2 receptor antagonist, is limited, but initial results are promising, particularly in pediatric patients. Administration of an IL-2 receptor antagonist with aggressive steroid minimization in selected, well-monitored patients seems reasonable, but further trials are required to define optimal protocols.

PMID: 15365604 [PubMed - indexed for MEDLINE]

Patient Drug Information

  • Cyclosporine (Neoral® , Sandimmune® , Gengraf® )

    Cyclosporine and cyclosporine (modified) are used with other medications to prevent transplant rejection (attack of the transplanted organ by the immune system of the person who received the organ) in people who have rec...

  • Sirolimus (Rapamune® )

    Sirolimus is used in combination with other medications to prevent rejection of kidney transplants. Sirolimus is in a class of medications called immunosuppressants. It works by suppressing the body's immune system.

  • Mycophenolate (CellCept® , Myfortic® )

    Mycophenolate (CellCept) is used with other medications to help prevent transplant organ rejection (attack of the transplanted organ by the immune system of the person receiving the organ) in people who have received kid...

  • Source: AHFS Consumer Medication Information