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Role of induction therapy in low immunological risk-kidney transplant recipients: A mate-kidney analysis.
Clin Transplant 2018; :e13442CT

Abstract

We aimed to evaluate the impact of induction on outcomes in low-immunological risk kidney transplant recipients (KTRs) using a mate-kidney model. Using OPTN/UNOS database, we identified three groups of low-immunological risk KTRs (first transplant, panel reactive antibody <20%, human leukocyte antigen mismatches ≤3) with each group containing recipients of mate-kidneys from same donor and differed by induction received: group 1: no induction vs interleukin-2 receptor antibody (IL2RA) induction; group 2: no induction vs depleting antibody induction; group 3: IL2RA vs depleting antibody induction. Outcomes were compared between mate-kidney recipients in each group in an adjusted model. Total of 1034 mate-kidney recipients were identified: group 1, n = 192; group 2, n = 362 and group 3, n = 480. Adjusted risk for DGF was higher (OR 1.89, 95% CI 1.09-3.25,.P = 0.02) and one-year acute rejection trended lower (OR 0.53, 95% CI 0.25-1.11, P = 0.09) among depleting antibody induced patients in group 2. Adjusted five-year graft survivals were similar between mate-kidney recipients in all three groups. Adjusted patient death risk was significantly lower in depleting antibody induced patients in group 2 (HR 0.48, 95% CI 0.26-0.88, P = 0.02) and trended lower in IL2RA induced patient in group 1 (HR 0.32, 95% CI 0.10-1.01, P = 0.05). Perioperative antibody induction was associated with lower patient death risk in low-immunologic risk KTRs.

Authors+Show Affiliations

Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.Nephrology, David Geffen School of Medicine, UCLA, Los Angeles, California.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30408257

Citation

Sureshkumar, Kalathil K., et al. "Role of Induction Therapy in Low Immunological Risk-kidney Transplant Recipients: a Mate-kidney Analysis." Clinical Transplantation, 2018, pp. e13442.
Sureshkumar KK, Katragadda V, Chopra B, et al. Role of induction therapy in low immunological risk-kidney transplant recipients: A mate-kidney analysis. Clin Transplant. 2018.
Sureshkumar, K. K., Katragadda, V., Chopra, B., & Sampaio, M. (2018). Role of induction therapy in low immunological risk-kidney transplant recipients: A mate-kidney analysis. Clinical Transplantation, pp. e13442. doi:10.1111/ctr.13442.
Sureshkumar KK, et al. Role of Induction Therapy in Low Immunological Risk-kidney Transplant Recipients: a Mate-kidney Analysis. Clin Transplant. 2018 Nov 8;e13442. PubMed PMID: 30408257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of induction therapy in low immunological risk-kidney transplant recipients: A mate-kidney analysis. AU - Sureshkumar,Kalathil K, AU - Katragadda,Vinaikumar, AU - Chopra,Bhavna, AU - Sampaio,Marcelo, Y1 - 2018/11/08/ PY - 2018/08/24/received PY - 2018/10/11/revised PY - 2018/10/21/accepted PY - 2018/11/9/pubmed PY - 2018/11/9/medline PY - 2018/11/9/entrez KW - induction KW - low immune risk KW - paired kidney analysis KW - transplant outcomes SP - e13442 EP - e13442 JF - Clinical transplantation JO - Clin Transplant N2 - We aimed to evaluate the impact of induction on outcomes in low-immunological risk kidney transplant recipients (KTRs) using a mate-kidney model. Using OPTN/UNOS database, we identified three groups of low-immunological risk KTRs (first transplant, panel reactive antibody <20%, human leukocyte antigen mismatches ≤3) with each group containing recipients of mate-kidneys from same donor and differed by induction received: group 1: no induction vs interleukin-2 receptor antibody (IL2RA) induction; group 2: no induction vs depleting antibody induction; group 3: IL2RA vs depleting antibody induction. Outcomes were compared between mate-kidney recipients in each group in an adjusted model. Total of 1034 mate-kidney recipients were identified: group 1, n = 192; group 2, n = 362 and group 3, n = 480. Adjusted risk for DGF was higher (OR 1.89, 95% CI 1.09-3.25,.P = 0.02) and one-year acute rejection trended lower (OR 0.53, 95% CI 0.25-1.11, P = 0.09) among depleting antibody induced patients in group 2. Adjusted five-year graft survivals were similar between mate-kidney recipients in all three groups. Adjusted patient death risk was significantly lower in depleting antibody induced patients in group 2 (HR 0.48, 95% CI 0.26-0.88, P = 0.02) and trended lower in IL2RA induced patient in group 1 (HR 0.32, 95% CI 0.10-1.01, P = 0.05). Perioperative antibody induction was associated with lower patient death risk in low-immunologic risk KTRs. SN - 1399-0012 UR - https://www.unboundmedicine.com/medline/citation/30408257/Role_of_induction_therapy_in_low_immunological_risk_kidney_transplant_recipients:_A_mate_kidney_analysis_ L2 - https://doi.org/10.1111/ctr.13442 DB - PRIME DP - Unbound Medicine ER -