Terapia de indução com alentuzumabe em receptores de transplante renal

Abstract

Introduction: Induction therapy has been used in sensitized patients, re-transplants, and in patients who have high risk to delayed graft function (DGF) after renal transplantation. Methods: Retrospective study with aim to compare transplant endpoints between recipients of deceased donors which have received induction with alemtuzumab (n = 9) versus thymoglobulin (n = 18). Patients were matched for age, duration of dialysis treatment and cold ischemia time. Results: There were no differences at demographic characteristics. All patients received kidney grafts from deceased donors and 67% of these donors met the expanded criteria. The incidence of DFG was similar in alemtuzumab and thymoglobulin groups, 55% and 56%. At 12 months, rates of rejection free survival (67% versus 89%, p = 0,13), graft survival (62,5% versus 76,6%; p = 0,73), graft with death censored (62,5% versus 76,6%; p = 0,82) and patient survival (83,3% versus 81,2%; p = 0,63) were similar between the two groups. Viral infections and renal function were similar between groups. At the end of the first month, alemtuzumab patients displayed a fewer lymphocyte number (135 ± 78 versus 263 ± 112 N/mm 3 , p < 0,05) followed by a more rapid recovery after 3 months (day 90: 683 ± 367 versus 282 ± 72 N/mm 3 ; p < 0,05). Cost associated with alemtuzumab and thymoglobulin inductions therapies were R$ 1,388.00 and R$ 7,398.00. Conclusion: In this cohort of patients, alemtuzumab induction showed efficacy and safety comparable to thymoglobulin but with significant cost reduction.

Comparative study between kidney transplantation with deceased donor expanded criteria and donor standard criteria in a single center in Brazil

“…These outcomes are consistent with recent studies. [34][35][36] Other authors have shown that ECD kidneys had worse long-term graft function and survival outcomes. 3,37 However, they provide acceptable function and significantly better patient survival when compared to dialysis.…”

Terapias Imunológicas Envolvendo O Uso De Anticorpos Monoclonais Na Rejeição De Transplantes Renais

“…15 Basiliximabe apresentou a mesma eficácia que o policlonal globulina anti-timocítica equina (ATG) e o inibidor de IL-2 Daclizumabem estudos, porém apresentou-se mais eficaz que o Muromonabe CD3, mostrando-se capaz de dispensar o uso de corticosteroides na terapia. 16 Em uso livre, não apresenta efeitos colaterais significativos, comparado com os imunossupressores convencionais. Porém, podem ocorrer alguns problemas gastrointestinais, dor abdominal, vômito, pressão baixa, dor de cabeça, tonturas, insônia, formigamentos, hiperglicemia, entre outros.…”