Basiliximab in High-risk Group: An African View Jacob Olugbenga Awobusuyi 1,2 , Julie M Bridson 2 , Ajay Sharma 2,3 and Ahmed Halawa 2,4* 1 Department of Medicine, Lagos State University College of Medicne (LASUCOM), Nigeria 2 Faculty of Health and Science, Institute of Learning and Teaching, University of Liverpool, UK 3 Royal Liverpool University Hospital, UK 4 Sheffield Teaching Hospitals, UK * Corresponding author: Ahmed Halawa, Consultant Transplant Surgeon, University of Sheffield-University of Liverpool, United Kingdom, E-mail: ahmed.halawa@sth.nhs.uk Received date: August 03, 2016; Accepted date: August 25, 2016; Published date: September 05, 2016 Copyright: © 2016 Awobusuyi JO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Abstract In organ transplantation, a wide variety of injurious events such as ischaemia-reperfusion injury, endothelial damage and the traumatic exposure of tissues during surgery occur intra-operatively. The barrage of multiple antigens presented to the recipient cause very intense immunological reaction to occur at the time of transplantation. Thus, an induction immunosuppressive protocol aimed at maximal immunosuppression in the peri-operative period when immunological stimulation is maximal is justified. Organ transplant recipients of African descent are generally considered as high immunological-risk patients in view of the intense immunological response to transplanted organs seen in these patients compared with their Caucasian counterparts. However, due to the huge additional cost of induction antibody medications, most centers in resource-poor economies in Africa base their induction protocol on high doses of calcineurin based triple-drug therapy. Outcomes from the centers have been considerably poorer in terms of allograft rejection, graft loss and patient survival, compared with other parts of the world where high-risk patients received antibody induction therapy. Basiliximab induction protocols may offer cost–benefit advantages in resource constrained centers compared with currently used calcineurin based triple-drug therapy. The clinical and financial benefits of reduced acute allograft rejection rates, graft loss and the excellent side effect profile Basiliximab in renal transplant recipients, potentially outweighs the additional costs incurred in the management of higher acute rejection rates, and graft loss in calcineurin based triple-drug therapy. This reflective review article, examines the possible role of Basiliximab induction protocol as a means of improving clinical outcomes of renal transplantation, in African transplant centres operating in financial constraint economies. Keywords: Basiliximab; Induction; Immunological risk; Renal; Transplantation; Africa; Nigeria Introduction Renal transplantation conceptually is the treatment of choice for Chronic Kidney Disease (CKD) patients with End Stage Renal Disease (ESRD) [1-4]. Studies comparing outcomes of renal replacement therapies have shown that overall survival is much longer in patients with renal transplantation compared with treatment with either haemodialysis or peritoneal dialysis. In addition, quality of life is adjudged better post renal transplantation compared with dialysis. So also, is the cost of treatment which is considerably lower in the long term for renal transplantation compared with staying on dialysis [3,4]. Renal transplantation is not with its own shortcomings [5,6]. Patients with renal transplantation are constantly at risk of allograf rejection (acute and chronic rejections) either as a result of prior sensitization or formation of de-novo donor specifc antibodies (DSA). To prevent these events, immunosuppressive protocols are designed towards minimization of acute graf rejection through massive immunosuppression by various induction strategies and maintenance of induced immunosuppression with maintenance immunosuppression protocols. However, drugs employed in these protocols have severe toxic side efects. For instance, nephrotoxicity resulting from calcineurin inhibitors may lead to graf loss in the transplant patient. Also, severe immunosuppression and other side efects of immunosuppressant medications may lead to the death of the patient with a functioning graf as a result of opportunistic infections, malignancies and cardiovascular disease [5,6]. In the absence of tolerance to the transplanted kidney, all renal transplant patients would require immunosuppressive therapy to prevent allograf rejection and graf loss. Te optimal immunosuppression regimen needs to be determined for the recipient [7,8], using existing clinical guidelines that are available to guide management of immunosuppression in transplant recipients [9]. Induction immunosuppression protocol strategies used in renal transplantation could be classifed into two. Te frst strategy uses high doses of conventional immunosuppressive medications to achieve intense immunosuppression in the perioperative period, while the second strategy utilizes biologic antibodies to T cells combined with low doses of conventional drugs to achieve the same goal [10]. In a Awobusuyi et al., J Transplant Technol Res 2016, 6:4 DOI: 10.4172/2161-0991.1000169 Review Article Open Access J Transplant Technol Res, an open access journal ISSN: 2161-0991 Volume 6 • Issue 4 • 1000169 Journal of Transplantation Technologies & Research J o u r n a l o f T r a n s p l a nt a t i o n T e c h n o l o g i e s & R e s e a r c h ISSN: 2161-0991