Terapia de inducción en trasplante renal

In duction therapy in renal transplantation is intended to re- duce acute rejection. Induction therapy is given with a anti- lymphocyte-depleting agent or receptor antagonist of interleu- kin-2 (IL2-RA) before starting, or just at the time immediately after transplantation. Evidence shows benefit in using IL2-RA against placebo in variable immunologic risk patients and different regimens of immunosuppression. There is moderate quality evidence that the use of a antilymphocyte-depleting agent against placebo reduces acute rejection and graft failure in patients with high immunological risk. There is also evi- dence that in patients with different immunological risk using lymphocyte-depleting agents compared with IL2-RA reduces the incidence of acute rejection but increases the risk of infec- tion and malignancy. From this evidence the use of induction therapy is recommended with a biological agent as part of the initial immunosuppressive therapy in renal transplant recipi- ents and it is recommended that IL2-RA agent is the first line induction therapy.