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Mycophenolate mofetil in pediatric renal transplantation: non-induction vs. induction with basiliximab

O Ojogho1, S Sahney, D Cutler

  • 1Transplantation Institute, Loma Linda University Medical Center, Loma Linda, CA 92354, USA. oojogho@ahs.llumc.ca

Pediatric Transplantation
|January 26, 2005
PubMed

Insights

Basiliximab induction therapy in pediatric kidney transplants using mycophenolate mofetil (MMF) showed similar short-term outcomes and survival rates compared to MMF alone. Further studies are needed to confirm basiliximab's role in MMF-treated pediatric renal transplantation.

Area of Science:

  • Nephrology
  • Immunology
  • Pediatric Transplantation

Background:

  • North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) reported adverse effects of OKT3 with mycophenolate mofetil (MMF) in pediatric renal transplant recipients.
  • Basiliximab, a monoclonal antibody targeting interleukin-2 receptors on activated T-lymphocytes, offers an alternative to OKT3.
  • Understanding the safety and efficacy of basiliximab in combination with MMF is crucial for optimizing immunosuppression protocols in pediatric kidney transplantation.

Purpose of the Study:

  • To evaluate the outcomes of pediatric renal transplantation using MMF with or without basiliximab induction therapy.
  • To compare acute rejection rates, patient survival, and graft survival between the two treatment groups.
  • To assess the safety profile and incidence of infections in MMF-treated pediatric renal transplant recipients with or without basiliximab.

Main Methods:

  • Retrospective analysis of 41 pediatric renal transplant recipients between January 1998 and June 2001.
  • Group I (n=25) received MMF, Prednisone, and either Cyclosporine (CSA) or Tacrolimus (TAC).
  • Group II (n=16) received MMF, Prednisone, CSA or TAC, in combination with basiliximab induction therapy.

Main Results:

  • At 6 months, acute rejection rates were comparable: 16% in Group I versus 25% in Group II (p=0.689).
  • Both groups achieved 100% patient and graft survival at 6 and 12 months.
  • Basiliximab was well-tolerated with no significant adverse events; infection rates (UTI, CMV) were similar between groups at 6 months.

Conclusions:

  • Short-term outcomes, including rejection rates and survival, are statistically similar for MMF with or without basiliximab in pediatric renal transplantation.
  • Basiliximab appears safe and well-tolerated in this pediatric cohort when used with MMF-based immunosuppression.
  • Further controlled studies are warranted to definitively establish the role of basiliximab in MMF-treated pediatric renal transplant recipients.

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