Basiliximab Induction for Safe Delay of Calcineurin Inhibitors in High MELD Liver Transplant Recipients.
1University of Maryland Medical Center, Baltimore, MD
2University of Maryland School of Medicine, Baltimore, MD.
Meeting: 2016 American Transplant Congress
Abstract number: B180
Keywords: Immunosuppression, Induction therapy, Liver transplantation, Simulect
Session Information
Session Name: Poster Session B: Kidney Issue in Liver Transplantation
Session Type: Poster Session
Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Available literature supports basiliximab induction for safe delay of CNI initiation and renal recovery; however there is a paucity of evidence for use in patients with MELD scores >20. The purpose of this study is to evaluate the effect of basiliximab induction on renal recovery, rejection, and infection in a liver transplant population with high MELD scores.
Methods: A retrospective chart review of adult liver transplant recipients from 2012-2014 with MELD scores >20 was conducted in patients who received steroids at time of transplant, with or without basiliximab induction. All patients received CNI maintenance immunosuppression. Patients were followed for one year post-transplantation.
Results: 70 patients were stratified into the basiliximab (n=35) and steroid only (n=35) cohorts. Baseline characteristics did not differ among groups with the exception of higher MELD scores in the basiliximab group (34.29 vs. 27.63, p=0.0005).
|
|
Basiliximab + Steroids n=35 |
Steroids Only n=35 |
P value |
|
Age in Years, mean±SD |
50.77 ±13.75 |
51.38 ±11.25 |
0.8497 |
|
Male Gender, n (%) |
20 (57.14) |
15 (42.86) |
0.6241 |
|
Ethnicity, n (%) African American Non-African American |
8 (22.86) 27 (77.14) |
10 (28.57) 25(71.43) |
0.1325 |
|
Pre-op MELD, mean±SD |
34.29 ±6.64 |
27.63 ±8.27 |
0.0005 |
|
Tacrolimus Levels, mean±SD 7 days 30 days 90 days |
4.28 ±2.81 7.15 ±4.71 7.48 ±3.52 |
6.23 ±3.52 6.67 ±3.77 7.43 ±4.05 |
0.0862 0.7254 0.8641 |
Basiliximab allowed CNI delay for 4.31 ±6.11 days versus 1.67 ±1.65 days in the steroid only group (p=0.0276). A significant change from baseline glomerular filtration rate was observed over 12 months in the basiliximab group (+14.51±3.12 mL/min/1.73 m2, p=0.0003). There was no difference in rejection between groups. An increased trend in bacterial infections requiring hospitalization occurred in the steroid only group by end of follow-up (28.57% vs. 3.45%, p=0.07). Variance in MELD scores did not affect graft or patient survival, both of which showed no difference between treatment groups.
Conclusion: Basiliximab induction in high MELD liver transplant recipients permits safe delay of CNI initiation and potential recovery of renal function.
CITATION INFORMATION: Clark J, Sparkes T, Masters B, LaMattina J, Barth R, Moss M. Basiliximab Induction for Safe Delay of Calcineurin Inhibitors in High MELD Liver Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Clark J, Sparkes T, Masters B, LaMattina J, Barth R, Moss M. Basiliximab Induction for Safe Delay of Calcineurin Inhibitors in High MELD Liver Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/basiliximab-induction-for-safe-delay-of-calcineurin-inhibitors-in-high-meld-liver-transplant-recipients/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress