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폐 이식 후 신부전 발생 환자에서 유지 면역억제제로서 basiliximab의 사용 평가

Medication Utilization Analysis of Basiliximab as a Maintenance Immunosuppressant in Renal Failure Patients Undergoing Lung Transplantation

한국임상약학회지 2020년 30권 3호 p.149 ~ 160
서예진, 금민정, 이경아, 김재송, 손은선, 유윤미,
소속 상세정보
서예진 ( Seo Ye-Jin ) - Yonsei University College of Medicine Severance Hospital Department of Pharmacy
금민정 ( Geum Min-Jung ) - Yonsei University College of Medicine Severance Hospital Department of Pharmacy
이경아 ( Lee Kyung-Ah ) - Yonsei University College of Medicine Severance Hospital Department of Pharmacy
김재송 ( Kim Jae-Song ) - Yonsei University College of Medicine Severance Hospital Department of Pharmacy
손은선 ( Son Eun-Sun ) - Yonsei University College of Medicine Severance Hospital Department of Pharmacy
유윤미 ( Yu Yun-Mi ) - Yonsei University College of Pharmacy

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.

키워드

Lung transplantation; basiliximab; acute kidney injury; renal failure; tacrolimus

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