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Antithymocyte globulin versus basiliximab induction for kidney transplantation in elderly patients: matched analysis within the Korean multicentric registry

Authors
 Jun Young Lee  ;  Sung Hwa Kim  ;  Yeon Ho Park  ;  Jae Berm Park  ;  Su Hyung Lee  ;  Jaeseok Yang  ;  Myoung Soo Kim  ;  Deok Gie Kim 
Citation
 KIDNEY RESEARCH AND CLINICAL PRACTICE, Vol.41(5) : 623-634, 2022-09 
Journal Title
KIDNEY RESEARCH AND CLINICAL PRACTICE
ISSN
 2211-9132 
Issue Date
2022-09
Keywords
Aged ; Diabetes mellitus ; Immunosuppressive agents ; Kidney transplantation ; Transplantation immunology
Abstract
Background: Basiliximab (BSX) and antithymocyte globulins (ATGs), are two major immunosuppressive agents commonly used as induction therapy for kidney transplant (KT) recipients. The superiority of ATG over BSX has not been well established, especially in elderly KT recipients with low immunological risk.

Methods: A total of 847 elderly (≥60 years old), low-risk KT patients in the Korean Organ Transplantation Registry were propensity score-matched at a 1:2 ratio and compared according to ATG or BSX induction therapy. The primary outcome was patient and graft survival and biopsy-proven acute cellular rejection. The secondary outcome was graft function, BK virus nephropathy, infection, cancer, new-onset diabetes mellitus after transplantation (NODAT), and delayed graft function.

Results: In total, 165 patients in the ATG group were matched with 298 patients in the BSX group with average ages of 64.3 and 64.2 years, respectively. During a follow-up of 28.5 ± 10.4 months, the cumulative probabilities of death-censored graft failure at 3 years posttransplantation were 1.3% and 1.4% in ATG and BSX groups, respectively, without a significant difference (p = 0.72). The cumulative probability of NODAT at 3 years posttransplantation was significantly higher in the BSX group (35.6% vs. 21.6%, p = 0.02). The median tacrolimus trough level was significantly lower at 6 months after KT in the ATG group (5.7 ng/mL vs. 6.4 ng/mL, p = 0.001). There were no differences in the other evaluated outcomes.

Conclusion: Compared with BSX, in elderly, low-risk KT patients, ATG reduced tacrolimus and steroid requirements without differences in all-cause mortality, rejection, or infection, resulting in a reduced NODAT incidence.
Files in This Item:
T202204735.pdf Download
DOI
10.23876/j.krcp.21.310
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Yang, Jaeseok(양재석)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191949
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