Randomized clinical trial of daclizumab induction and delayed introduction of tacrolimus for recipients of non-heart-beating kidney transplants

Authors: Wilson, C. H.¹; Brook, N. R.²; Gok, M. A.¹; Asher, J. F.¹; Nicholson, M. L.²; Talbot, D.¹

Source: British Journal of Surgery, Volume 92, Number 6, June 2005 , pp. 681-687(7)

Publisher: John Wiley & Sons, Ltd.

Abstract:

Background:

Kidneys from non-heart-beating donors (NHBDs) have high rates of delayed graft function (DGF). Use of calcineurin inhibitors is associated with a reduction in renal blood flow, which may delay graft recovery from ischaemic acute tubular necrosis.

Methods:

To assess whether daclizumab (DZB) could safely replace tacrolimus in the immediate postoperative period, patients were randomized to receive DZB induction and daily mycophenolate mofetil with steroids (DZB group) or standard tacrolimus-based triple therapy (control group). Tacrolimus was given to patients in the DZB group when the serum creatinine level dropped below 350 µmol/l.

Results:

Fifty-one patients were recruited at two centres over a 2-year interval between 2000 and 2003. The overall rate of immediate function was 28 per cent (13 of 46 grafts), with the highest rate in recipients of machine-perfused kidneys treated with DZB (eight of 15 patients).

Conclusion:

Induction with DZB and delayed introduction of tacrolimus reduced the incidence of DGF in recipients of machine-perfused NHBD kidneys. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Document Type: Miscellaneous

DOI: http://dx.doi.org/10.1002/bjs.4976

Affiliations: 1: Liver/Renal Unit, The Freeman Hospital, Newcastle upon Tyne, UK 2: Division of Transplant Surgery, Leicester General Hospital, Leicester, UK

Publication date: 2005-06-01

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