Reperfusion edema after lung transplantation: Effect of daclizumab

PURPOSE: To determine if daclizumab, an interleukin-2 antagonist, reduced t he severity of reperfusion edema in lung transplant recipients. MATERIALS AND METHODS: Eighty-five patients who were to undergo 86 consecut ive lung transplants were included; 43 (50%) received daclizumab in additio n to conventional immunosuppression. Patients were assigned to one of the f ollowing groups: control, right allograft; control, left allograft; daclizu mab treated, right allograft; daclizumab treated, left allograft. Radiograp hs obtained in the first 5 postoperative days were evaluated for degree of edema. Mean daily edema scores and curves for control and daclizumab-treate d groups were compared. Differences in survival at 1, 3, 6, and 12 months a fter transplantation, days of mechanical ventilation, and the ratio of arte rial oxygenation to inspired oxygen level at 1, 3, and 5 days after transpl antation were also compared. RESULTS: Mean daily edema scores, edema curves, survival, days of mechanica l ventilation, and ratio of arterial oxygenation to inspired oxygen level a t 1 and 3 days after transplantation did not significantly differ between d aclizumab-treated and control groups. A trend toward improved survival in t he daclizumab-treated group was noted. CONCLUSION: Daclizumab had no effect on the radiographic or immediate clini cal manifestations of reperfusion edema in lung transplant recipients. Addi tional follow-up is needed to determine if daclizumab offers any long-term benefit in terms of reduced rejection rates or survival.