Efficacy of Anti-Interleukin-2 Receptor Antibody (Daclizumab) in Reducing the Incidence of Acute Rejection After Renal Transplantation

Background: acute rejection remains a major problem in renal transplantation and represents one of the most important causes of chronic allograft dysfunction and late graft loss. daclizumab is a genetically engineered human igg1 monoclonal antibody that binds specifically to the α chain of the interleukin-2 receptor, and may thus reduce the risk of rejection after renal transplantation. objectives: the aim of this study was to examine the effect of daclizumab induction therapy combined with a triple immunosuppressive protocol including prednisolone, cyclosporine microemulsion (csa), and mycophenolate mofetil (mmf), in reducing the incidence of acute rejection in recipients of living unrelated donor kidneys. patients and methods: in this historical cohort study, 43 adult recipients of their first kidney allograft received daclizumab (three 1 mg/kg doses administered every 2 weeks) with triple immunosuppressive therapy (steroids, csa, and mmf). this group was compared to 43 first-time graft recipients who received maintenance triple immunosuppressive therapy comprising steroids, csa, and mmf. the end point was the incidence of biopsyconfirmed acute rejection within 6 months after transplantation. results: at 6 months, 5 (11.6%) of the patients in the daclizumab group had biopsy-proven rejections, as compared to 14 (32.5%) in the control group (p = 0.017). the sex and the age of recipients had no impact on the incidence of acute rejection episodes in the two groups. conclusions: adding interleukin-2 receptor antibody (daclizumab) to maintenance triple immunosuppressive therapy (prednisolone, csa, and mmf) reduces the incidence of acute rejection episodes at 6 months in first-time transplant recipients of living unrelated donor.