BACKGROUND: Induction therapy with interleukin-2 receptor antagonists has been established as an effective immunosuppressive strategy in the management of heart transplant (HTx) recipients. We compared outcomes following HTx in patients receiving basiliximab, daclizumab, or no induction therapy. METHODS AND RESULTS: We investigated post-transplant prognosis of patients receiving basiliximab (n=67), daclizumab (n=98) or no induction therapy (n=70). Patients treated with daclizumab (50.3 ± 14.7 years) were younger than those receiving basiliximab (55.8 ± 11.2 years) or no induction therapy (54.9 ± 14.1 years; both P<0.05). Patients receiving either induction therapy showed better survival 1 year after HTx (95%) than those without induction therapy (82%; P<0.001). Survival was similar between patients receiving basiliximab and daclizumab. The incidence of acute cellular or antibody-mediated rejections did not differ among the groups. The main reason that patients did not receive induction therapy was ongoing infection (65.7%), which was more common in patients on ventricular assist device (VAD) support than those without VAD (76.1% vs. 45.8%; P=0.004). The VAD-related infection rate in the entire study cohort was 29.7% (35/118 VAD recipients). CONCLUSIONS: Survival following HTx was worse in patients not receiving induction therapy. No differences were noted in survival or the incidence of rejection between the daclizumab- and basiliximab-treated groups. Induction therapy was less used in patients with infection, which was related to prior VAD support.
BACKGROUND: Induction therapy with interleukin-2 receptor antagonists has been established as an effective immunosuppressive strategy in the management of heart transplant (HTx) recipients. We compared outcomes following HTx in patients receiving basiliximab, daclizumab, or no induction therapy. METHODS AND RESULTS: We investigated post-transplant prognosis of patients receiving basiliximab (n=67), daclizumab (n=98) or no induction therapy (n=70). Patients treated with daclizumab (50.3 ± 14.7 years) were younger than those receiving basiliximab (55.8 ± 11.2 years) or no induction therapy (54.9 ± 14.1 years; both P<0.05). Patients receiving either induction therapy showed better survival 1 year after HTx (95%) than those without induction therapy (82%; P<0.001). Survival was similar between patients receiving basiliximab and daclizumab. The incidence of acute cellular or antibody-mediated rejections did not differ among the groups. The main reason that patients did not receive induction therapy was ongoing infection (65.7%), which was more common in patients on ventricular assist device (VAD) support than those without VAD (76.1% vs. 45.8%; P=0.004). The VAD-related infection rate in the entire study cohort was 29.7% (35/118 VAD recipients). CONCLUSIONS: Survival following HTx was worse in patients not receiving induction therapy. No differences were noted in survival or the incidence of rejection between the daclizumab- and basiliximab-treated groups. Induction therapy was less used in patients with infection, which was related to prior VAD support.
Authors: Josef Stehlik; Leah B Edwards; Anna Y Kucheryavaya; Christian Benden; Jason D Christie; Fabienne Dobbels; Richard Kirk; Axel O Rahmel; Marshall I Hertz Journal: J Heart Lung Transplant Date: 2011-10 Impact factor: 10.247
Authors: Susan Stewart; Gayle L Winters; Michael C Fishbein; Henry D Tazelaar; Jon Kobashigawa; Jacki Abrams; Claus B Andersen; Annalisa Angelini; Gerald J Berry; Margaret M Burke; Anthony J Demetris; Elizabeth Hammond; Silviu Itescu; Charles C Marboe; Bruce McManus; Elaine F Reed; Nancy L Reinsmoen; E Rene Rodriguez; Alan G Rose; Marlene Rose; Nicole Suciu-Focia; Adriana Zeevi; Margaret E Billingham Journal: J Heart Lung Transplant Date: 2005-06-20 Impact factor: 10.247
Authors: Anne I Dipchand; Richard Kirk; Leah B Edwards; Anna Y Kucheryavaya; Christian Benden; Jason D Christie; Fabienne Dobbels; Lars H Lund; Axel O Rahmel; Roger D Yusen; Josef Stehlik Journal: J Heart Lung Transplant Date: 2013-10 Impact factor: 10.247
Authors: Mandeep R Mehra; Mark J Zucker; Lynne Wagoner; Robert Michler; John Boehmer; John Kovarik; Arthur Vasquez Journal: J Heart Lung Transplant Date: 2005-09 Impact factor: 10.247
Authors: A Beniaminovitz; S Itescu; K Lietz; M Donovan; E M Burke; B D Groff; N Edwards; D M Mancini Journal: N Engl J Med Date: 2000-03-02 Impact factor: 91.245
Authors: Ray E Hershberger; Randall C Starling; Howard J Eisen; Claes-Håkan Bergh; Robert L Kormos; Robert B Love; Adrian Van Bakel; Robert D Gordon; Rina Popat; Louise Cockey; Richard D Mamelok Journal: N Engl J Med Date: 2005-06-30 Impact factor: 91.245
Authors: Christopher R Ensor; William D Cahoon; Michael L Hess; Vigneshwar Kasirajan; Richard H Cooke Journal: Prog Transplant Date: 2009-12 Impact factor: 1.065