Induction Therapy in Lung Transplantation: Initial Single-Center Experience Comparing Daclizumab and Antithymocyte Globulin

Lischke, Robert; Šimonek, Jan; Davidová, R.; Schützner, J; Stolz, A; Vojáček, Jan; Burkert, Jan; Pafko, Pavel

doi:10.1016/j.transproceed.2006.10.030

Cited by 28 publications

(18 citation statements)

References 22 publications

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“…While mechanical ventilation is provided only in the intensive care unit, in the medium care unit, mobilizations and physical activity are limited. The total hospital stay in the present cohort was 30 days (IQR 23 to 44 days), which is clearly longer than that reported in some centers (20), but typical for our center (21) and others (22,23). On the ward patients in this study received routine chest physiotherapy, mobilization, light exercises and functional rehabilitation (i.e.…”

Section: Discussioncontrasting

confidence: 40%

Skeletal Muscle Force and Functional Exercise Tolerance Before and After Lung Transplantation: A Cohort Study

Maury

Langer

Verleden

et al. 2008

American Journal of Transplantation

121

109

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We investigated the impact of lung transplantation and outpatient pulmonary rehabilitation after lung transplantation on skeletal muscle function and exercise tolerance. Skeletal muscle force (Quadriceps force, QF), exercise tolerance (six minute walking distance, 6MWD) and lung function were assessed in 36 patients before and after lung transplantation. Seventeen male and 19 female patients (age 57 ± 4) showed skeletal muscle weakness before the transplantation. A further 32 ± 21% reduction was seen 1.2 (interquartile range 0.9 to 2.0) months after LTX. The number of days on the intensive care unit was significantly related to the observed deterioration in muscle force after LTX. At this time point 6MWD was comparable to pre-LTX.Rehabilitation started 37 (IQR 29 to 61) days after LTX. 6MWD and QF improved significantly (140 ± 91 m, and 35 ± 48%, respectively; p < 0.05) with rehabilitation. QF remained below pre-LTX values. The evolution of the 6MWD with the transplantation and the subsequent rehabilitation was less in female compared to male subjects. We conclude that muscle strength deteriorates after lung transplantation, particularly in patients with long ICU stay. Outpatient pulmonary rehabilitation is feasible after lung transplantation and leads to recovery of skeletal muscle function. In female patients this recovery is significantly less compared to male recipients.TT and LD are Post-doctoral research fellows of the Scientific Foundation Flanders. DL is a research fellow of the Scientific Foundation Flanders.

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Section: Discussioncontrasting

confidence: 40%

Skeletal Muscle Force and Functional Exercise Tolerance Before and After Lung Transplantation: A Cohort Study

Maury

Langer

Verleden

et al. 2008

American Journal of Transplantation

121

109

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“…Daclizumab was first shown to be effective in the reduction of acute rejection episodes in patients undergoing renal transplantation [1][2] and has since been utilized for other solid organ transplants including heart [3], lung [4][5], pancreatic [6][7], and hepatic allografts [8][9]. Besides its use in solid organ transplantation, daclizumab has been utilized for the treatment of a subset of patients with human T-cell leukemia virus-1 (HTLV-1) associated T-cell leukemia because of the elevated levels of IL-2 receptor found on leukemic cell populations [10].…”

Section: Introductionmentioning

confidence: 99%

High-dose humanized anti-IL-2 receptor alpha antibody (daclizumab) for the treatment of active, non-infectious uveitis

Yeh

Wroblewski

Buggage

et al. 2008

Journal of Autoimmunity

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Purpose-This study was designed to provide preliminary data regarding the safety and efficacy of high-dose humanized anti-IL-2 receptor (daclizumab) therapy for the treatment of active intermediate, posterior or panuveitis.Methods-Five patients were recruited into this non-randomized, prospective pilot study of highdose intravenous induction daclizumab therapy given at doses of 8 mg/kg at day 0 and 4 mg/kg at day 14. Patients who did not meet a safety endpoint at the 3-week follow-up evaluation were given the option of continuing therapy with subcutaneous daclizumab at 2 mg/kg every 4 weeks for 52 weeks. The primary outcome assessed was a 2-step decrease in vitreous haze at day 21. Secondary outcomes evaluated included best-corrected visual acuity, retinal thickness as measured by optical coherence tomography, retinal vascular leakage assessed by fluorescein angiography, anterior chamber and vitreous cellular inflammation.Results-4 male patients and 1 female patient were enrolled. Diagnoses included birdshot retinochoroidopathy (2 patients), Vogt-Koyanagi-Harada's disease, bilateral idiopathic panuveitis and bilateral idiopathic intermediate uveitis. By the 4 th week, four of five patients demonstrated a 2-step decrease in vitreous haze. The other participant did not meet this criterion until week 20, but all 5 patients maintained stability in vitreous haze grade throughout their follow-up periods. At enrollment, mean visual acuity (10 eyes in five patients) was 69.2 ETDRS letters and following treatment was 78.2 letters (p < 0.12). Anterior chamber cell, vitreous cell, and vitreous haze also improved in the majority of eyes. Adverse events were generally mild except for one episode of leftlower lobe pneumonia requiring hospitalization and treatment.Conclusion-This is the first demonstration that high-dose daclizumab can reduce inflammation in active uveitis. Daclizumab was well-tolerated but there may be a potential increased risk of infection associated with immunosuppression. All five patients demonstrated a decrease in vitreous haze and measures of intraocular inflammation at final follow-up. The results of this small,

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“…163 However, in a follow-up study by the same group with longer-term follow-up, there was no difference in freedom of AR !1, and there was no difference in freedom of BOS, infection, malignancy, or survival. 164 In other studies of lung transplant recipients, the incidence of AR was lower with daclizumab compared with ATG in some, [165][166][167] but not all 17,168 studies. The incidence of BOS was lower with daclizumab in one study 165 and similar to ATG in two studies.…”

Section: Induction Therapymentioning

confidence: 95%

“…The incidence of BOS was lower with daclizumab in one study 165 and similar to ATG in two studies. 167,168 In a nonrandomized trial, induction therapy with alemtuzumab was associated with greater freedom from rejection compared with ATG or daclizumab. 169 The most important message may be that prospective, multicenter studies are needed to determine if and which induction therapy is beneficial in lung transplantation.…”

Section: Induction Therapymentioning

confidence: 99%

Chronic Allograft Rejection: Epidemiology, Diagnosis, Pathogenesis, and Treatment

Weigt

Wallace²,

Derhovanessian³

et al. 2010

Semin Respir Crit Care Med

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Lung transplantation is a therapeutic option for patients with end-stage pulmonary disorders. Unfortunately, chronic lung allograft rejection, in the form of obliterative bronchiolitis and its clinical correlate bronchiolitis obliterans syndrome (BOS), continues to be highly prevalent and is the major limitation to long-term survival. The pathogenesis of BOS is complex and involves alloimmune and nonalloimmune pathways. The airway obstruction involved is classically progressive and unresponsive to treatment; however, the course is highly variable, and distinguishable phenotypes may exist. A better understanding of the risk factors and their relationship to the pathological mechanisms of chronic lung allograft rejection should lead to better pharmacological targets to prevent or treat this syndrome.

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Induction Therapy in Lung Transplantation: Initial Single-Center Experience Comparing Daclizumab and Antithymocyte Globulin

Cited by 28 publications

References 22 publications

Skeletal Muscle Force and Functional Exercise Tolerance Before and After Lung Transplantation: A Cohort Study

Skeletal Muscle Force and Functional Exercise Tolerance Before and After Lung Transplantation: A Cohort Study

High-dose humanized anti-IL-2 receptor alpha antibody (daclizumab) for the treatment of active, non-infectious uveitis

Chronic Allograft Rejection: Epidemiology, Diagnosis, Pathogenesis, and Treatment

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