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Outcomes of thymoglobulin versus basiliximab induction therapies in living donor kidney transplant recipients with mild to moderate immunological risk – a retrospective analysis of UNOS database

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posted on 2023-05-26, 13:20 authored by Hatem Ali, Mahmoud Mohammed, Tibor Fülöp, Shafi Malik

The aim of this study is to assess the outcomes of different induction therapies among mild to moderate immunological risk kidney transplants in the era tacrolimus and mycophenolate-derivate based maintenance.

This was a retrospective cohort study using data from the United States Organ Procurement and Transplantation Network among mild to moderate immunological risk living-donor KTRs, defined as having first transplant and panel reactive antibodies less than 20% but with two HLA-DR mismatches. KTRs were divided into two groups based on induction therapy with either thymoglobulin or basiliximab. Instrumental variable regression models were used to assess the effect of induction therapy on acute rejection episodes, serum creatinine levels and graft survival.

Of the entire cohort, 788 patients received basiliximab while 1727 patients received thymoglobulin induction. There were no significant differences between basiliximab versus thymoglobulin induction in acute rejection episodes at one-year post-transplant (coefficient= −0.229, p value = .106), serum creatinine levels at one-year post-transplant (coefficient= −0.024, p value = .128) or death-censored graft survival (coefficient: − <0.001, p value = .201).

This study showed no significant difference in acute rejection episodes or graft survival when using thymoglobulin or basiliximab in mild to moderate immunological risk living donor KTRs, maintained on tacrolimus and mycophenolate-based immunosuppressive regimen.

Funding

The authors alone are responsible for the content and writing of the paper. Dr. Fülöp is a current employee of the United States Veterans Health Administration. However, the opinions and views expressed in this paper are the Authors’ own and do not represent the official views or policies of the United States Veteran Health Administrations. The authors declare that no funding was received for this study.

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