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Thymoglobulin Versus Basiliximab Induction Therapy in Low-Risk Kidney Transplant Recipients: A Single-Center Experience.
- Source :
-
Transplantation proceedings [Transplant Proc] 2018 Jun; Vol. 50 (5), pp. 1285-1288. - Publication Year :
- 2018
-
Abstract
- Background: The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend that T-cell-depleting agents should be used only for kidney transplant (KT) recipients at high immunologic risk. However, the effects of thymoglobulin induction therapy in low-immunologic risk KT recipients on tacrolimus, mycophenolic acid, and steroid have not been elucidated yet.<br />Methods: We retrospectively collected 6 months postoperative clinical data, for low-immunologic risk KT recipients at Soonchunhyang University Hospital. Recipients were divided into thymoglobulin and basiliximab groups, based on the induction agent used. Low-immunologic risk recipients were defined as those with panel-reactive antibody level <30% at the time of kidney transplantation. The incidence of biopsy-proven acute rejection and borderline change was compared between the two groups.<br />Results: Of the 46 low-immunologic risk patients, 25 received thymoglobulin. The incidence of biopsy-proven acute rejection was 0% (n = 0) and that of borderline change was 8% (n = 2) in the thymoglobulin group. The basiliximab group had a significantly higher incidence of rejection (23.8%; n = 5; P = .015) and borderline change (42.9%; n = 9; P = .006). No significant difference in estimated glomerular filtration rate was found between the two groups at 6 months after kidney transplantation. Cytomegalovirus (CMV) infection occurred more frequently in the thymoglobulin group than in the basiliximab group. All patients with CMV infection in both groups were effectively treated with pre-emptive intravenous ganciclovir therapy.<br />Conclusions: In low-immunologic risk KT recipients who received tacrolimus, mycophenolic acid, and steroid therapy, thymoglobulin induction therapy significantly reduced the incidence of biopsy-proven acute rejection and borderline change compared with basiliximab induction therapy.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Basiliximab
Cytomegalovirus Infections prevention & control
Female
Graft Rejection epidemiology
Graft Rejection immunology
Humans
Incidence
Induction Chemotherapy methods
Male
Middle Aged
Mycophenolic Acid therapeutic use
Postoperative Complications epidemiology
Postoperative Complications immunology
Postoperative Complications prevention & control
Retrospective Studies
Steroids therapeutic use
Tacrolimus therapeutic use
Treatment Outcome
Antibodies, Monoclonal therapeutic use
Antilymphocyte Serum therapeutic use
Graft Rejection prevention & control
Immunosuppressive Agents therapeutic use
Kidney Transplantation adverse effects
Recombinant Fusion Proteins therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2623
- Volume :
- 50
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 29880348
- Full Text :
- https://doi.org/10.1016/j.transproceed.2018.02.088