Low-Dose Thymoglobulin versus Basiliximab Induction Therapy in Low-Risk Living Related Kidney Transplant Recipients: Three-Year Follow-Up Study.

Autor: Martinez-Mier G; Department of Organ Transplantation, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico; Department of Research, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico. Electronic address: gmtzmier@hotmail.com., Moreno-Ley PI; Department of Organ Transplantation, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico., Budar-Fernández LF; Department of Organ Transplantation, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico., Méndez-López MT; Department of Organ Transplantation, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico., Allende-Castellanos CA; Department of Organ Transplantation, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico., Jiménez-López LA; Department of Organ Transplantation, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico., Barrera-Amoros DA; Department of Organ Transplantation, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico., Reyes-Ruiz JM; Department of Research, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, Ver. Mexico.
Jazyk: angličtina
Zdroj: Archives of medical research [Arch Med Res] 2024 Sep; Vol. 55 (6), pp. 103047. Date of Electronic Publication: 2024 Jul 29.
DOI: 10.1016/j.arcmed.2024.103047
Abstrakt: Background: The optimal dose of rabbit anti-thymocyte globulin (r-ATG) in renal transplantation is still under debate. We previously reported that a low-dose r-ATG induction of 3 mg/kg can be used safely and effectively in low-risk kidney transplants with good results in the first year after transplantation compared to basiliximab induction.
Aims: The purpose of this study is to evaluate the long-term impact of this trial of low-dose r-ATG versus basiliximab on post-transplant outcomes (patient and graft survival, biopsy-proven acute rejection incidence [BPAR], infectious complications, and side effects).
Methods: Observational study (three-year follow-up) of a 12-month single-center, open-label RCT in de novo kidney allograft recipients assigned to receive either thymoglobulin or basiliximab before transplantation.
Results: Patients in the basiliximab group (BG) underwent more kidney transplant biopsies than patients in the low-dose r-ATG group (TG) (50 vs. 31.8%, p = 0.07). Although the 12-month cumulative incidence of BPAR was lower in BG, by the end of the three-year follow-up period this incidence was higher (22%) than in the low-dose TG (15%) (p = ns). Steroids were withdrawn more frequently in the TG group and sirolimus was most frequently indicated. Graft function and graft survival were higher in the low-dose TG than in the BG at three-year follow-up but not statistically significant. Patient survival was similar between groups (>90%).
Conclusions: These three-year follow-up data confirm the efficacy and favorable safety aspects of the low-dose r-ATG (3 mg/kg) in low-risk kidney transplantation.
(Copyright © 2024 Instituto Mexicano del Seguro Social (IMSS). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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