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A randomized controlled trial of daclizumab versus anti-thymocyte globulin induction for heart transplantation.

Mullen JC, Kuurstra EJ, Oreopoulos A, Bentley MJ, Wang S - Transplant Res (2014)

Bottom Line: Recipient, donor, and intraoperative variables did not differ significantly between groups.Average absolute lymphocyte and platelet counts were significantly higher in the DZM group.One year survival was excellent in both groups (87%, P = 0.1).

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Cardiac Surgery, University of Alberta Hospital, Edmonton, AB, Canada ; Division of Cardiac Surgery, University of Alberta Hospital, 2D2.18 WMC, 8440 112 Street, Edmonton, AB T6G 2B7, Canada.

ABSTRACT

Background: The purpose of this study was to test the efficacy and safety of daclizumab (DZM) versus anti-thymocyte globulin (ATG) as a component of induction therapy in heart transplant recipients.

Methods: Thirty heart transplant patients were randomized to receive either ATG or DZM during induction therapy. Patients in the DZM group received an initial dose of 2 mg/kg intravenous (IV) at the time of transplant and 1 mg/kg IV on postoperative day 4.

Discussion: Recipient, donor, and intraoperative variables did not differ significantly between groups. The cost of induction therapy, total drug cost, and hospital ward costs were significantly less for the DZM group. Average absolute lymphocyte and platelet counts were significantly higher in the DZM group. There were no significant differences in the incidence of rejection, infection, malignancy, or steroid-induced diabetes. One year survival was excellent in both groups (87%, P = 0.1). Daclizumab is a safe component of induction therapy in heart transplantation.

No MeSH data available.


Related in: MedlinePlus

Cost analysis: total hospital cost (P = 0.8).
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Figure 2: Cost analysis: total hospital cost (P = 0.8).

Mentions: The cost analysis is illustrated in Figure 2. Induction cost (cost of DZM vs. cost of ATG) was significantly lower in the DZM group (Figure 2, $5,337 ± 308, CI ± 604.17 vs. $7,384 ± 799, CI ± 1,565.84, P = 0.03). Total drug cost (induction cost plus methylprednisolone, mycophenalate mofetil, cyclosporine A and/or tacrolimus, and prednisone) was also significantly lower in the DZM group (Figure 2, $6,044 ± 328, CI ± 642.28 vs. $8,133 ± 828, CI ± 1,622.97, P = 0.03). In addition, hospital ward (step-down unit) cost was lower in the DZM group (Figure 2, $11,353 ± 3,320, CI ± 6,507.38 vs. $14,376 ± 3,526, CI ± 6,911.53, P <0.05). Intensive care unit stay and total hospital costs were not significantly different between groups (Figure 2).


A randomized controlled trial of daclizumab versus anti-thymocyte globulin induction for heart transplantation.

Mullen JC, Kuurstra EJ, Oreopoulos A, Bentley MJ, Wang S - Transplant Res (2014)

Cost analysis: total hospital cost (P = 0.8).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4120716&req=5

Figure 2: Cost analysis: total hospital cost (P = 0.8).
Mentions: The cost analysis is illustrated in Figure 2. Induction cost (cost of DZM vs. cost of ATG) was significantly lower in the DZM group (Figure 2, $5,337 ± 308, CI ± 604.17 vs. $7,384 ± 799, CI ± 1,565.84, P = 0.03). Total drug cost (induction cost plus methylprednisolone, mycophenalate mofetil, cyclosporine A and/or tacrolimus, and prednisone) was also significantly lower in the DZM group (Figure 2, $6,044 ± 328, CI ± 642.28 vs. $8,133 ± 828, CI ± 1,622.97, P = 0.03). In addition, hospital ward (step-down unit) cost was lower in the DZM group (Figure 2, $11,353 ± 3,320, CI ± 6,507.38 vs. $14,376 ± 3,526, CI ± 6,911.53, P <0.05). Intensive care unit stay and total hospital costs were not significantly different between groups (Figure 2).

Bottom Line: Recipient, donor, and intraoperative variables did not differ significantly between groups.Average absolute lymphocyte and platelet counts were significantly higher in the DZM group.One year survival was excellent in both groups (87%, P = 0.1).

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Cardiac Surgery, University of Alberta Hospital, Edmonton, AB, Canada ; Division of Cardiac Surgery, University of Alberta Hospital, 2D2.18 WMC, 8440 112 Street, Edmonton, AB T6G 2B7, Canada.

ABSTRACT

Background: The purpose of this study was to test the efficacy and safety of daclizumab (DZM) versus anti-thymocyte globulin (ATG) as a component of induction therapy in heart transplant recipients.

Methods: Thirty heart transplant patients were randomized to receive either ATG or DZM during induction therapy. Patients in the DZM group received an initial dose of 2 mg/kg intravenous (IV) at the time of transplant and 1 mg/kg IV on postoperative day 4.

Discussion: Recipient, donor, and intraoperative variables did not differ significantly between groups. The cost of induction therapy, total drug cost, and hospital ward costs were significantly less for the DZM group. Average absolute lymphocyte and platelet counts were significantly higher in the DZM group. There were no significant differences in the incidence of rejection, infection, malignancy, or steroid-induced diabetes. One year survival was excellent in both groups (87%, P = 0.1). Daclizumab is a safe component of induction therapy in heart transplantation.

No MeSH data available.


Related in: MedlinePlus