Anticuerpos anti-receptor de la interleucina-2 para la prevención del rechazo en receptores de trasplante de hígado: una revisión sistemática y meta-análisis.

BACKGROUND:

Antibody induction therapy aims to prevent acute cellular rejection by reducing T-cell proliferation and activation. We evaluated the efficacy and side effects of two anti-interleukin-2 receptor antibodies (IL2RA), basiliximab and daclizumab, for prevention of liver transplant rejection in adult patients.

METHODS:

Randomized controlled trials on basiliximab or daclizumab were identified by searching multiple databases and reference lists published up to July, 2015. Endpoints included acute rejection events and mortality rates. Risk ratio (RR) and 95% confidence interval were calculated and pooled for a meta-analysis.

RESULTS:

Patients treated with IL2RA-based therapy were less likely to suffer acute rejection compared to control group (steroid or steroid-free). Patients in all groups had similar mortality rate. In the subgroup analysis, Basiliximab and Daclizumab-based therapies did not reduced acute rejection rate. No significant difference was found in mortality rate between both types of IL-2RA treatment groups and control groups. In the subgroup analysis regarding experimental design, no significant difference in the acute rejection and mortality rates were found between "steroid plus IL2RA vs. steroid" and "IL2RA vs. steroid" groups.

CONCLUSION:

IL2RA-based induction therapy reduces rate of acute rejection events but does not reduce mortality. However, optimal regimen relating to IL2RA-based induction therapy remains undetermined.