Cyclosporine-sparing effect of basiliximab in renal transplant recipients with mycophenolate mofetil

Basiliximab added to a maintenance regimen consisting of cyclosporine microemulsion and mycophenolate mofetil was studied for its effectiveness in allowing early steroid withdrawal in renal transplantion. Furthermore, the cyclosporine-sparing effects between groups with and without basiliximab induction therapy were compared. Patients. Between September 2001 and June 2003, 90 patients underwent renal transplants with cyclosporine-based immunosuppression, namely, cyclosporine, mycophenolate mofetil, and methylprednisolone, (group I; n = 25). During the latter half of the study basiliximab was administered during the induction phase (group 2; n = 65). In group 2, steroids were completely withdrawn on postoperative day 14 in 57 patients. Results. The incidence of acute rejection was significantly higher among group I patients (P =.005). The incidence of steroid-resistant rejection in group I patients was significantly higher (P =.025). At each time point cyclosporine levels in group I patients were significantly higher (P <.01). The incidence of infection was comparable between the groups. Patient and graft survival rates in group I were 100% and 100%; in group 2, they were 99% and 99%, respectively. In group 2, steroids were discontinued in 57 patients with permanent withdrawal achieved in 32 patients (56%). Conclusion. The use of basiliximab, together with mycophenolate mofetil allowed for a significant reduction in the cyclosporine dose without increasing the risk of acute rejection. Although further follow-up is necessary to confirm the effect, this regimen may attenuate cyclosporine nephrotoxicity thereby affecting the long-term outcomes of renal transplantation.