Single centre experience with basiliximab in paediatric renal transplantation

Area of Science:

• Pediatric Nephrology
• Transplantation Immunology
• Pharmacology

Background:

• Interleukin-2 (IL-2) receptor antagonists have proven effective in reducing acute rejection in adult renal transplant recipients.
• Limited data exists regarding the efficacy and safety of these agents in pediatric renal transplantation.

Purpose of the Study:

• To evaluate the efficacy and safety of basiliximab in pediatric renal transplant recipients.
• To compare outcomes between children receiving basiliximab with standard immunosuppression versus standard immunosuppression alone.

Main Methods:

• A cohort of 77 pediatric patients (0.5-16 years) underwent renal transplantation between 1997-2000.
• 48 patients received basiliximab, cyclosporine A (CsA), and prednisolone; 29 received CsA and prednisolone only.
• Outcomes including acute rejection, survival, glomerular filtration rate (GFR), and side effects were monitored for 3 years.

Main Results:

• All patients survived the observation period; 1-year graft survival was high in both groups (95% vs 93%).
• Basiliximab significantly reduced acute rejection incidence (14% vs 34%).
• Initial lower GFR in the basiliximab group normalized by 1 year, associated with higher CsA levels.

Conclusions:

• Basiliximab demonstrates excellent allograft survival and a reduced incidence of acute rejection in pediatric renal transplantation.
• The agent is associated with minimal side effects, supporting its use.
• Basiliximab is recommended for routine immunosuppressive therapy in pediatric renal transplant recipients.