Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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Medication Utilization Analysis of Basiliximab as a Maintenance Immunosuppressant in Renal Failure Patients Undergoing Lung Transplantation

폐 이식 후 신부전 발생 환자에서 유지 면역억제제로서 basiliximab의 사용 평가

  • Seo, Yejin (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Geum, Min Jung (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Lee, Kyung Ah (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Kim, Jae Song (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Son, Eun Sun (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Yu, Yun Mi (Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, College of Pharmacy, Yonsei University)
  • 서예진 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 금민정 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 이경아 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 김재송 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 손은선 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 유윤미 (연세대학교 약학대학)
  • Received : 2020.04.22
  • Accepted : 2020.08.03
  • Published : 2020.09.30
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Abstract

Background: Basiliximab is used as an alternative to tacrolimus in patients with decreased renal function. However, studies on basiliximab as a maintenance immunosuppressant, particularly in patients with lung transplantation, are limited. Therefore, here, we investigated the efficacy and safety of basiliximab in patients with lung transplantation. Methods: Adult patients with acute kidney injury (AKI) who received lung transplantation at a single general hospital between July 1, 2014 and June 30, 2018, were selected and classified in tacrolimus and basiliximab groups. Both groups received a triple-drug regimen (tacrolimus, mycophenolate mofetil, and steroids). However, tacrolimus was discontinued in the basiliximab group when AKI occurred, and two or more repeat basiliximab doses were administered within 3 months after transplantation. The electronic medical records were analyzed retrospectively. Results: Of the 85 patients who met the selection criteria, 61 and 24 were assigned to the tacrolimus and basiliximab groups, respectively. Significant improvement in renal function was observed in the basiliximab group (p <0.001). However, there were no differences in acute and chronic rejection rates in both the groups. No difference was observed in the incidence rate of complications between the groups, except for chronic kidney disease, which showed higher incidence in the basiliximab group (25.0% vs. 4.9%; p =0.013). Conclusions: We suggest the use of basiliximab as an immunosuppressant alternative to tacrolimus in patients with acute renal failure after lung transplantation. Basiliximab demonstrated effectiveness as an immunosuppressant and improved renal function. Therefore, basiliximab can be used in patients with decreased renal function.

Keywords

References

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