Clinical Correlates and Outcomes of Dual Basiliximab and Antithymocyte Globulin Induction in Kidney Transplant Recipients: A National Study

Overview

Journal Transplant Direct

Publisher Wolters Kluwer

Specialty General Surgery

Date 2022 Jul 15

PMID 35836670

Authors

Ngan N Lam

Rachel Jeong

Robert R Quinn

Pietro Ravani

Huiling Xiao

Mara McAdams-DeMarco

David A Axelrod

Mark A Schnitzler

Jon J Snyder

Krista L Lentine

Affiliations

Soon will be listed here.

Abstract

Methods: We used national transplant registry data to study clinical correlates and outcomes of single versus dual induction therapy in adult kidney-only transplant recipients in the United States (2005-2018). The risk of death and graft loss at 1 and 5 y, according to induction therapy type, was assessed using multivariate Cox regression analysis (adjusted hazard ratio with 95% upper and lower confidence limits [aHR]).

Results: Of the 157 351 recipients included in the study, 67% were treated with ATG alone, 29% were treated with IL2rAb alone, and 5% were treated with both. Compared with IL2rAb alone, the strongest correlates of dual induction included Black race, calculated panel reactive antibody ≥80%, prednisone-sparing maintenance immunosuppression, more recent transplant eras, longer cold ischemia time, and delayed graft function. Compared with ATG alone, dual induction was associated with an increased 5-y risk of death (aHR 1.15; < 0.0001), death-censored graft failure (aHR 1.13; < 0.05), and all-cause graft failure (aHR 1.12; < 0.0001).

Conclusions: Further research is needed to develop risk-prediction tools to further inform optimal, individualized induction protocols for kidney transplant recipients.

Citing Articles

Porcine anti-human lymphocyte immunoglobulin depletes the lymphocyte population to promote successful kidney transplantation.

Zhang L, Zou H, Lu X, Shi H, Xu T, Gu S Front Immunol. 2023; 14:1124790.

PMID: 36969156 PMC: 10033525. DOI: 10.3389/fimmu.2023.1124790.

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