Long-term outcome of ATG vs. Basiliximab induction

Eur J Clin Invest. 2011 Sep;41(9):971-8. doi: 10.1111/j.1365-2362.2011.02490.x. Epub 2011 Mar 7.

Abstract

Background: An evaluation of the long-term efficacy and incidence of adverse events after induction therapy with antithymocyte globulin (ATG) vs. Basiliximab in renal transplant patients.

Methods: Sixty recipients receiving ATG induction and a dual immunosuppression with Tacrolimus and steroids were compared retrospectively with 60 patients treated with Basiliximab. The following characteristics were evaluated: concomitant immunosuppression, recipient age, donor age, time on dialysis, cold ischemia time, year of transplantation and HLA mismatches.

Results: The 6-year patient survival in the ATG group was 91·7% compared to 85% in the Basiliximab group (not significant, n.s.). Graft survival at 6 years was 89·7% and. 83·6% in the ATG and the Basiliximab group (n.s.), respectively. Incidence of biopsy proven acute rejection episodes (33·3% vs. 26·7%) and delayed graft function (30% vs. 33·3%) were similar in both groups. Kidney function was not significantly different at 1 and 6 years. CMV infections were more prevalent in the ATG arm (22% vs. 5%; P = 0·05), and a significantly higher rate of haematological complications was observed following ATG induction.

Conclusions: ATG induction was associated with an improved (but n.s.) trend in patient and graft survival. Patients induced with ATG had a higher rate of CMV infections and haematological complications.

MeSH terms

  • Adult
  • Analysis of Variance
  • Antibodies, Monoclonal / therapeutic use*
  • Antilymphocyte Serum / therapeutic use*
  • Basiliximab
  • Female
  • Graft Rejection / prevention & control*
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Recombinant Fusion Proteins / therapeutic use*
  • Remission Induction
  • Survival Analysis
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antilymphocyte Serum
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Basiliximab