Efficacy and safety of basiliximab as initial immunosuppression in liver transplantation: A single center study

Ann Hepatol. 2020 Sep-Oct;19(5):541-545. doi: 10.5604/01.3001.0012.2246. Epub 2020 Aug 5.

Abstract

Introduction and aim: The interleukin-2 receptor antagonist; basiliximab is used to allow delayed introduction of Calcineurin inhibitors (CNI) after liver transplantation and thus delay their renal insult. However, there is only little evidence for the safety and the efficacy of this regimen. This study aimed to evaluate the effectiveness and safety of basiliximab induction in liver transplantation.

Materials and methods: This study included 89 patients who were classified into two groups: standard triple immunosuppression (IS) regimen of steroid, tacrolimus (TAC) and mycophenolate mofetil (MMF) (n = 47) and induction IS regimen of basiliximab, low dose steroids and MMF with delayed introduction of CNI (n = 42). All patients were followed after liver transplantation for at least six months or until death.

Results: There were no significant differences in patient survival, graft dysfunction, infection rate or type, or wound healing between both groups. The acute rejection rate was equivalent in both groups. Renal dysfunction in the first six months post-transplant was less in the basiliximab group in comparison to the other group (7.1% and 19.1% respectively).

Conclusion: Basiliximab-induced IS protocol is a safe regimen that reduces medium-term renal dysfunction and achieves similar survival without increasing the acute rejection or infection rate in liver transplantation recipients.

Keywords: Basiliximab; Calcineurin inhibitors; Immunosuppression; Rejection; Transplantation; interleukin-2.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Basiliximab / adverse effects
  • Basiliximab / therapeutic use*
  • Calcineurin Inhibitors / therapeutic use
  • Drug Therapy, Combination
  • Egypt
  • Female
  • Graft Rejection / immunology
  • Graft Rejection / mortality
  • Graft Rejection / prevention & control*
  • Graft Survival / drug effects*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / mortality
  • Male
  • Middle Aged
  • Mycophenolic Acid / therapeutic use
  • Steroids / therapeutic use
  • Tacrolimus / therapeutic use
  • Time Factors
  • Treatment Outcome

Substances

  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Steroids
  • Basiliximab
  • Mycophenolic Acid
  • Tacrolimus