Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab

Cell Transplantation

Article

Toshihiko Hirano¹  Kentaro Sugiyama¹  Akira Toyama²  Satoshi Horisawa²  Hiroshi Satoh²  Kazuya Isogai²  Yuki Nakagawa³  Kazuhide Saito³  Masayuki Tasaki³  Kota Takahashi³ 

[1] Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Science, Tokyo, Japan;Division of Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan;Division of Urology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan;

关键词: Tacrolimus;    Basiliximab;    Renal transplantation;    Lymphocyte immunosuppressant sensitivity test (LIST);    Peripheral blood mononuclear cells (PBMCs);   

DOI  :  10.3727/096368911X605493

 received in 2010-03-31, accepted in 2011-07-18,  发布年份 2012

来源: Sage Journals

【 摘 要 】

Basiliximab is a recently developed immunosuppressive agent for the prevention of acute allograft rejection in renal transplant recipients. The combination use of basiliximab and a calcineurin inhibitor was suggested to be more effective in comparison to immunosuppressive therapy using calcineurin inhibitor without basiliximab. Cyclosporine has been generally administered with basiliximab for renal transplant recipients. However, in cases of tacrolimus-based immunosuppressive regimen, the clinical efficacy and safety of combined use of tacrolimus and basiliximab remains to be elucidated. This study evaluated the tacrolimus pharmacological efficacy using a lymphocyte immunosuppressant sensitivity test (LIST) with MTT assay procedures in 16 cases of renal transplant recipients treated by tacrolimus without basiliximab and in 13 cases treated by tacrolimus in combination with basiliximab. The rate of acute rejection episodes in the recipients treated with tacrolimus plus basiliximab was 1/13 (7.7%), whereas the rate in the recipients treated with tacrolimus without basiliximab was 6/16 (37.5%). The recipients were divided into two groups according to their peripheral blood mononuclear cell (PBMC) sensitivity to tacrolimus [i.e., including a tacrolimus high sensitivity group (IC50 <1.0 ng/ml) and a low sensitivity group (IC50 >1.0 ng/ml). In the recipients treated with tacrolimus without basiliximab, the rate of acute rejection episodes in the tacrolimus high sensitivity group was 1/10 (10.0%), which was significantly lower than the rate in the low sensitivity group of 5/6 (83.3%; p = 0.008). The incidence of cytomegalovirus infection was not significantly different between the tacrolimus high and the low sensitivity groups of the recipients treated with tacrolimus with and without basiliximab. Therefore, in the case of selected tacrolimus-based immunosuppressive therapy for renal transplant recipients, the tacrolimus pharmacological efficacy should be evaluated using LIST at a time just before the transplant procedure in order to accurately predict allograft rejection. The data also suggested that low tacrolimus sensitivity recipients should be treated with tacrolimus-based immunosuppressive therapy in combination with basiliximab.

【 授权许可】

Unknown   
© 2012 Cognizant Comm. Corp.

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