Sequential blood level monitoring of basiliximab during multisession plasmapheresis in a kidney transplant recipient
In: Proceedings of the 20th International Congress of the Transplantation Society. Part II: Clinical transplantation practiceTransplantation proceedings 37(2):875-878; Jg. 37 (2005) 2, S. 875-878
Konferenz
- print, 7 ref
Zugriff:
Basiliximab, a chimeric monoclonal antibody against the alpha chain of the interleukin-2 receptor (IL-2R) has been used in renal transplant patients. We monitored sequential blood concentrations of basiliximab in a patient who received a kidney transplant with basiliximab-based immunosuppression together with multiple sessions of plasmapheresis. A 34-year-old man received a living-related kidney transplant with induction immunosuppression including tacrolimus, mycophenolate, methylprednisolone, and basiliximab. Severe antibody-mediated acute rejection lead to a requirement for hemodialysis. Deoxyspergualin was administered for 10 days at a daily dose of 5 mg/kg combined with eight sessions of double filtration plasmapheresis (DFPP). After treatment, the serum creatinine returned to 0.95 mg/dL, and there were no major complications or infections. Sequential basiliximab blood levels of the patient were monitored following transplantation. The serum basiliximab concentration decreased by 72.4% after five consecutive DFPPs, and by 87.6% after eight DFPP sessions. The elimination rate of basiliximab (ABLX) was 6.1% before DFPP, but increased over eight DFPPs to 20.5%. Serum basiliximab concentrations declined to 0.16 μg/mL on day 33, which is below the IL-2R saturation concentration (0.2 μg/mL). Multiple sessions of plasmapheresis using DFPP enhanced the elimination of serum basiliximab at an average elimination rate of 19.1%. In the patient reported on here, the serum basiliximab concentration fell to below the IL-2R saturation level (0.2 μg/mL) within 1 month of living-related kidney transplantation. We recommend that additional basiliximab infusions be considered for cases undergoing more than three plasmapheresis sessions.
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Sequential blood level monitoring of basiliximab during multisession plasmapheresis in a kidney transplant recipient
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Autor/in / Beteiligte Person: | NOJIMA, M ; YOSHIMOTO, T ; NAKAO, A ; ITAHANA, R ; KYO, M ; HASHIMOTO, M ; SHIMA, H |
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Quelle: | Proceedings of the 20th International Congress of the Transplantation Society. Part II: Clinical transplantation practiceTransplantation proceedings 37(2):875-878; Jg. 37 (2005) 2, S. 875-878 |
Veröffentlichung: | New York, NY: Elsevier Science, 2005 |
Medientyp: | Konferenz |
Umfang: | print, 7 ref |
ISSN: | 0041-1345 (print) |
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