October 25, 2024, Immune Tolerance
As the number of patients with end-stage renal disease continues to rise, the number of kidney transplantation procedures has increased annually, and antibody induction therapy has become increasingly common. Antibody induction therapy involves the use of biological protein agents, specifically antibodies, as an early form of immunosuppressive therapy following organ transplantation. The incidence of acute rejection in the early post-transplantation period following a citizen’s death donation kidney transplant ranges from 30% to 50%, imposing significant economic and psychological burdens on patients. Therefore, induction therapy is essential to reduce the incidence of acute rejection after kidney transplantation. Additionally, induction therapy can delay the use of calcineurin inhibitor (CNI) drugs, such as cyclosporine and tacrolimus, to minimize their nephrotoxicity. The most widely used induction therapy for kidney transplantation is the interleukin-2 (IL-2) receptor antagonist. It was first introduced clinically in 1997 and approved by the FDA for induction therapy. It specifically binds to the α subunit of the IL-2 receptor complex on the surface of T lymphocytes, effectively inhibiting T-cell activation and reducing acute rejection. Compared to other induction therapy antibodies, it offers a favorable safety profile and does not significantly elevate the risk of infection or malignancy.
Both Chinese and international organ transplant experts have amassed extensive clinical experience and research data on the use of IL-2 receptor antagonists to prevent acute rejection, unanimously acknowledging their efficacy and safety. Major guidelines recommend IL-2 receptor antagonists as the first-line option for induction therapy following organ transplantation. The KDIGO (Kidney Disease: Improving Global Outcomes) guidelines for managing kidney transplant recipients recommend IL-2 receptor antagonists as the first-line option for induction therapy in kidney transplantation. They highlight that the perioperative period of kidney transplantation features an active immune response and a high incidence of acute rejection, with induction immunotherapy aimed at preventing graft failure due to acute rejection. The EAU (European Association of Urology Guidelines for Kidney Transplantation) recommends IL-2 receptor antagonists for induction therapy in kidney transplantation. The Chinese Medical Association also recommends IL-2 receptor antagonists as a first-line treatment for induction therapy in kidney transplantation.
The Kidney Transplant Center at Zhongshan Hospital, affiliated with Fudan University, possesses extensive experience in kidney transplantation and welcomes consultations. We will work together with you to alleviate the suffering caused by uremia.
Written by | Zhu Dong, Illustrations | Zou Garland
This article is an original publication of the “Kidney Transplantation, Zhongshan Hospital, Fudan University” WeChat public account. Reproduction requires authorization from this account and the original author, with proper attribution. To care for your kidneys, begin by following the “Kidney Transplantation, Zhongshan Hospital, Fudan University” WeChat public account. You can also click [Read the Original] to explore The Past and Present of Kidney Transplantation: Part II.
