Interleukin-2 receptor blockade with humanized monoclonal antibody for solid organ transplantation

Abstract

Importance of the field: Induction therapy has reduced the incidence of acute rejection compared with historical standards. The potency of currently available induction immunosuppression is not without risk and should be carefully considered. Induction with daclizumab, an IL-2 receptor antagonist, has been used safely and effectively for over 10 years across different transplant types. As a result of daclizumab use, transplant centers are able to implement steroid-sparing or calcineurin minimization protocols. Unfortunately, the manufacturing costs have resulted in withdrawal of this agent from the market reducing the options for patients undergoing transplantation.

Areas covered in this review: This review will update the reader on recently published daclizumab studies in adult solid organ transplant recipients, focusing on comparative studies with other induction agents.

What the reader will gain: This paper will provide a summary of comparative studies between daclizumab and other induction therapies focusing on their efficacy and safety.

Take home message: Novel applications, such as long-term use in combination with calcineurin-inhibitor dose reduction and its value in the treatment of acute or chronic rejection have yet to be explored. Since daclizumab has been withdrawn from the market, future IL-2 receptor blockade will have to be achieved with basiliximab, which is a chimeric, monoclonal antibody directed against the same epitope.

Keywords::

• daclizumab
• IL-2 receptor inhibitor
• induction immunosuppression
• solid organ transplantation