Page 65 - Heart Transplant Protocol

Heart Function Service: Heart Transplant Protocols

Protocol for Administration of Basiliximab (Simulect®)

Basiliximab is a chimeric (murine/human) monoclonal antibody directed against the interleukin-2
receptor α-chain (CD25 antigen) on the surface of activated T-lymphocytes, thus competitively inhibiting
IL-2 mediated activation of lymphocytes. It is approved for the prophylaxis of acute organ rejection in
patients receiving renal transplantation with concomitant immunosuppressant. Renal transplant team
recommends basiliximab as the induction agent for living donor kidney transplant and any deviation is at
the discretion of the attending physician.
Dose:
Children < 35 kg:
Initial dose: 10 mg administered within 2 hours prior to organ reperfusion.
Second dose: 10 mg administered 4 days after transplantation

Children > 35 kg and Adults:
Initial dose: 20 mg administered within 2 hours prior to organ reperfusion.
Second dose: 20 mg administered 4 days after transplantation

Hold second dose if complications occur (including severe hypersensitivity reactions or graft loss)

Administration:
Preparation: Basiliximab should be diluted in 25 ml (10mg dose) or 50 ml (20mg dose) of 0.9%NaCl or
D5W for IV infusion. Diluted basiliximab should be used immediately. If not, it can be stored at 2°C to
8°C for 24 hours or at room temperature for 4 hours.
Premedication: None necessary
Infusion Rate: Infuse over 20 – 30 minutes by itself. Bolus administration may be associated with
nausea, vomiting and local reactions, including pain.
Monitoring Parameters: Vital Signs Q 15 min during infusion and for 30 min. post infusion

Side Effects:
Severe acute (onset within 24 hours) hypersensitivity reactions including anaphylaxis have been
observed both on initial exposure to basiliximab and/or subsequent exposure. These reactions may
include hypotension, tachycardia, cardiac failure, dyspnea, wheezing, bronchospasm, pulmonary edema,
respiratory failure, urticarial, rash, pruritus, and/or sneezing, as well as capillary leak syndrome and
cytokine release syndrome, have been reported during post-marketing experience. Basiliximab did not
increase the incidence of adverse events observed compared with placebo. Product Information:
SIMULECT(R) injection, basiliximab injection. Novartis Pharmaceuticals Corporation, East Hanover, NJ, 2005.

Updated November 9, 2017 65