Efficacy of Daclizumab in an African-American and Hispanic renal transplant population

Current immunosuppressive regimens have decreased acute rejection rates during the 1st year after renal transplantation. However, this decrease has not been as marked in high-risk groups, such as African-American and Hispanic renal transplant recipients. We compared two simultaneous cohorts of altogether 36 African-American and Hispanic renal transplant recipients. Cohort one received a regimen of mycophenolate mofetil, prednisone, and a calcineurin inhibitor. The second cohort received the same protocol with the addition of Daclizumab (1 mg/kg for five doses given every 2 weeks). The median follow-up was 15.2 months (range 11.8-19.9 months). One patient in the Daclizumab-treated group and seven patients in the control group experienced an acute rejection episode. The rejection-free survival was significantly higher in the Daclizumab-treated group (94.4%) (66.7%, Log-rank < 0.05) at 17 months after transplantation. A Cox Proportional Hazard model revealed lack of Daclizumab therapy as the only significant risk factor for acute rejection. (hazard ratio 7.0, 95% CI = 1.1-48). The addition of the IL-2 receptor blocker Daclizumab to a triple therapy regimen may decrease early acute rejection in the high-risk groups of African-American and Hispanic patients.