Controversies About Induction Therapy

Abstract Induction therapy refers to the initiation of intense immunosuppression in the initial days after transplantation when the recipient's immune system contacts donor antigens for the first time. Induction therapy may also be used to permit delayed initiation of calcineurin inhibitors (CN...

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Bibliographic Details
Published in:Transplantation proceedings 2011-07, Vol.43 (6), p.2450-2452
Main Authors: Ippoliti, G, Pellegrini, C, Nieswandt, V
Format: Article
Language:English
Subjects:
Biological and medical sciences
Delayed Graft Function - etiology
Delayed Graft Function - prevention & control
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Graft Rejection - immunology
Graft Rejection - prevention & control
Graft Survival - drug effects
Humans
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Medical sciences
Organ Transplantation - adverse effects
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tissue, organ and graft immunology
Treatment Outcome
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Summary:Abstract Induction therapy refers to the initiation of intense immunosuppression in the initial days after transplantation when the recipient's immune system contacts donor antigens for the first time. Induction therapy may also be used to permit delayed initiation of calcineurin inhibitors (CNIs) for maintenance immunosuppression among patients with significant renal failure (RF). The rationale of its use is to provide intensive immunosuppression at the time when the alloimmune response is most intense. In general, induction therapy can be divided into 2 categories: depleting antibodies (eg, polyclonal antibodies [horse or rabbit antithymocyte globulin], anti-CD3 antibodies [OKT3], and human monoclonal anti-CD52 [alentuzumab]) and nondepleting antibodies (eg, anti-CD25 antibodies [daclizumab, basiliximab] or fusion proteins with natural binding properties currently being studied, eg, CTLA4-Ig [belatacept]). The advantages and disadvantages of induction therapy are discussed.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2011.06.021