eCommons@AKU

Title

Outcomes after anti-thymocyte globulin vs Basiliximab induction before deceased donor kidney transplants

Authors

Muhammad Saad Hafeez, Aga Khan UniversityFollow
Muneeb Ul Haq, Aga Khan UniversityFollow
Syed Shahyan Bakhthiyar, University of Colorado, United States of America
Kumael Azhar, Aga Khan UniversityFollow
Ahmed Arslan Yousuf Awan, Baylor College of Medicine, United States of America
Bhamidipati V Ramana Murthy, Baylor College of Medicine, United States of America
Rana Abbas, Baylor College of Medicine, United States of America

Document Type

Article

Department

Medical College Pakistan

Abstract

Background: Deceased donor kidney transplants represent an important source of renal replacement for the 100 000 patients initiating hemodialysis annually. We compared the association of induction therapy, anti-thymocyte globulin [rabbit] (rATG) or basiliximab, with posttransplant rejection, graft and patient survival.
Methods: Using the United Network for Organ Sharing (UNOS) database, we identified patients that received deceased donor kidney transplants. The outcomes analyzed were 6- month rejection, 1-year rejection, patient survival and graft survival. Multivariate logistic regression models were constructed to understand the association of induction therapy and rejection. Cox-proportional hazards models were constructed to ascertain the association of choice of induction therapy with both patient and graft survival.
Results: Of 45 339 patients, 33 906 patients received rATG induction therapy and 11 433 patients received basiliximab induction therapy. The rATG group were younger (53.44 years vs 55.28 years, P < 0.001), more frequently female (58.74% male vs 66.08%, P < 0.001) and more frequently Black (34.78% vs 25.66%, p < 0.001) compared with patients in the basiliximab group. Rejection was more likely with basiliximab compared with rATG at 6 months(OR = 1.64, P < 0.001; 7.81% Basiliximab vs 5.23% rATG)and at 12 months (OR = 1.56, P < 0.001; 8.81% Basiliximab vs 6.31% rATG). Basiliximab induction therapy was associated with worse patient survival, (HR = 1.05, P = 0.017). Basiliximab induction therapy was associated with worse graft survival, (HR = 1.03, P = 0.037).
Conclusion: The analysis of the national experience demonstrated favorable rejection, patient survival, and graft survival with rATG usage. Further prospective data are necessary to provide treatment recommendations.

Comments

Issue and pagination are not provided by the author/publisher

Publication ( Name of Journal)

Transplant immunology

Recommended Citation

Hafeez, M. S., Haq, M. U., Bakhthiyar, S. S., Azhar, K., Awan, A. Y., Murthy, B. V., Abbas, R. (2022). Outcomes after anti-thymocyte globulin vs Basiliximab induction before deceased donor kidney transplants. Transplant immunology, 75.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_mc/314