Prolonged basiliximab use as an alternative to calcineurin inhibition to allow renal recovery late after heart transplantation

Solid-organ transplant patients can have a number of complications, some of which are particularly severe with regard to morbidity and mortality. These complications may be due to operative and post-operative complications or to the immunosuppressive therapy regimen. Renal impairment is a frequent post-transplant complication that may occur for any number of reasons, including peri-operative ischemic events and nephrotoxicity secondary to anti-rejection medications. Calcineurin inhibitors (CNIs) in particular can lead to acute renal failure (ARF).(1-5) There are no clear guidelines for the management of ARF after heart transplantation. Different strategies include delaying initiation of CNI therapy post transplant, and the use of anti-CD25 monoclonal antibodies.(6-9)