Daclizumab induction in solid organ transplantation

Antibody induction therapy is used in solid organ transplantation to prevent rejection in the early postoperative period. It is especially useful in high-risk groups such as retransplants, patients with delayed graft function to delay the initiation of nephrotoxic calcineurin inhibitors (tacrolimus, cyclosporin), highly sensitised recipients and African-American recipients. Historically, antibody induction has been associated with a high incidence of adverse effects and a complicated administration regimen. Daclizumab is a monoclonal antibody that exerts its effect by binding to the alpha subunit (CD25) of the human interleukin (IL)-2 receptor on the surface of activated lymphocytes, thus preventing the binding of IL-2. It is used for induction therapy and is well-tolerated with easy administration. Although originally studied as a five-dose regimen, there is a growing accumulation of data that fewer doses (two or three) are efficacious and less costly for preventing rejection.