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

✍ Scribed by C. H. Wilson; N. R. Brook; M. A. Gok; J. F. Asher; M. L. Nicholson; D. Talbot

• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 116 KB
• Volume: 92
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.4976

✦ Synopsis

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.