Purpose: Daclizumab and Basiliximab have been demonstrated to decrease the frequency of acute rejection(AR) in the first 6 months after renal transplantation without side effects. Preliminary data on the use of these drugs for induction immunosuppression in lung transplantation was reviewed in 19 consecutive lung transplant recipients at this institution.
Methods: Daclizumab was administered to a total of 9 patients: 5 double lung (DLT) and 4 single lung (SLT) transplant recipients. Basiliximab was given to a total of 10 patients: 4 DLT and 6 SLT. Both drugs were administered using published standard regimens. The first dose in both groups was given at the time of surgery. The incidence of AR during the first 6 months post transplant and potential complications of immunosupression were evaluated (frequency of significant infection, leukopenia, thrombocytopenia, and anemia).
Conclusion: Hematopoietic side effects were not seen. The frequency of AR with induction Daclizumab or Basiliximab therapy seems increased relative to renal transplantation. The frequency of acute rejection episodes in the Daclizumab group appeared higher in the DLT recipients while it was equally distributed between DLT and SLT recipients in the Basiliximab group.
Clinical Implications: Controlled studies evaluating the benefits of the use of either Daclizumab or Basiliximab in lung transplantation are warranted. The value of these drugs in induction immunosuppression in lung requires close scrutiny of efficacy and consideration of dosage review.
Javier A Jover, MD(*) and A E Frost, MD. Medicine, Baylor College of Medicine & The Methodist Hospital, Houston, TX.3
COPYRIGHT 1999 American College of Chest Physicians
COPYRIGHT 2000 Gale Group