Effects of Induction Therapy on Graft Functions in Terms of Immunologic Risk

Transplant Proc. 2023 Sep;55(7):1551-1554. doi: 10.1016/j.transproceed.2023.02.067. Epub 2023 Jul 5.

Abstract

Background: Advances in immunosuppressive therapies and surgical techniques have led to a significant reduction in the incidence of rejection within 1 year after kidney transplantation. Immunologic risk is an important factor affecting graft functions and guiding the clinician in the selection of induction therapy. The aim of this study was to investigate graft functions based on serum creatinine levels, Chronic Kidney Disease Epidemiology Collaboration (CKD- EPI) and proteinuria levels, frequency of leukopenia, cytomegalovirus (CMV) and BK virus polymerase chain reaction (PCR) positivity in patients with low and high immunologic risk.

Material and methods: This retrospective study included 80 renal recipients. Recipients were divided into 2 groups: patients at low immunologic risk who received basiliximab only and those with high immunologic risk who received low-dose (1.5 mg/kg for 3 days) antithymocyte globulin and basiliximab.

Results: No significant differences were observed between the 2 risk groups in terms of first, third, sixth, and 12th-month creatinine levels, CKD-EPI, proteinuria levels, leukopenia frequency, and CMV and BK virus PCR positivity.

Conclusion: One-year graft survivals did not differ significantly between these 2 treatment modalities. The combined use of low-dose antithymocyte globulin and basiliximab in the induction treatment of patients with high immunologic risk seems promising in terms of graft survival, leukopenia frequency, and CMV and BK virus PCR positivity.

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antilymphocyte Serum / adverse effects
  • Basiliximab
  • Cytomegalovirus Infections* / chemically induced
  • Cytomegalovirus Infections* / diagnosis
  • Cytomegalovirus Infections* / drug therapy
  • Graft Rejection
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Induction Chemotherapy
  • Proteinuria / chemically induced
  • Recombinant Fusion Proteins
  • Renal Insufficiency, Chronic* / chemically induced
  • Retrospective Studies

Substances

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