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Thymoglobulin versus basiliximab induction therapy for simultaneous kidney-pancreas transplantation: impact on rejection, graft function, and long-term outcome
- Source :
- Transplantation. 92(9)
- Publication Year :
- 2011
-
Abstract
- Background Thymoglobulin (ATG) and basiliximab induction therapies are used by the majority of centers for pancreas transplantation today. Although both strategies have different mechanisms, there is a paucity of studies comparing them. We compared the efficacy and side effects of both methods in simultaneous pancreas-kidney (SPK) transplantation. Methods We analyzed 128 SPKs at our institution between January 2001 and August 2008. Forty-nine patients received basiliximab (40 mg), whereas 79 patients had ATG (5 mg/kg). Graft function, complications, rejection, and survival rates were analyzed. Results ATG versus basiliximab therapy was associated with decreased 3-month (6% vs. 21%; P=0.01) and 1-year (14% vs. 27%; P=0.049) rejection rate. Steroid-resistant rejections were decreased with ATG (3%) vs. basiliximab (14%) (P=0.01). In a univariate regression analysis, basiliximab induction was a risk factor for rejection (HR, 7.1; CI, 3.8-13). No differences were observed regarding complications and graft function up to 5 years. ATG versus basiliximab therapy resulted in identical 1-year (90% vs. 93%), 3-year (87% vs. 89%), and 5-year (78% vs. 83%) pancreas survival (P=0.7). No difference was observed in kidney survival after 1 year (99% vs. 98%), 3 years (97% vs. 98%), and 5 years (95% vs. 95%) (P=0.4). Conclusions ATG versus basiliximab induction therapy results in decreased acute cellular rejection in the first year after SPK with similar side effects. Long-term graft function and survival are not affected by induction regimen.
- Subjects :
- Adult
Graft Rejection
Male
medicine.medical_specialty
Basiliximab
medicine.medical_treatment
Recombinant Fusion Proteins
Urology
Pancreas transplantation
Risk Factors
medicine
Humans
Longitudinal Studies
Risk factor
Survival rate
Antilymphocyte Serum
Retrospective Studies
Transplantation
Thymoglobulin
business.industry
Graft Survival
Antibodies, Monoclonal
Retrospective cohort study
Kidney Transplantation
Survival Rate
Regimen
Treatment Outcome
Regression Analysis
Female
Pancreas Transplantation
business
Immunosuppressive Agents
medicine.drug
Subjects
Details
- ISSN :
- 15346080
- Volume :
- 92
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Transplantation
- Accession number :
- edsair.doi.dedup.....64ff34a8f96b84b6805c74f5bee6fdcb