Induction Immunosuppressive Therapy Use in Deceased Donor Kidney Transplantation: 11-Year Experience in Veracruz, Mexico

Autor: Gustavo Martínez-Mier, Luis F Budar-Fernández, Sandro F Ávila-Pardo, María Fernanda Trujillo-Martínez, A. Uscanga-Montesano, L.J. Mateu-Rivera, Marco T Méndez-López, Ernesto Soto-Miranda, D. Avila y Falfan
Rok vydání: 2016
Předmět:
Graft Rejection
Male
Basiliximab
medicine.medical_treatment
030232 urology & nephrology
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
0302 clinical medicine
Child
Kidney transplantation
Cause of death
education.field_of_study
Graft Survival
Antibodies
Monoclonal

Immunosuppression
Middle Aged
Tissue Donors
Child
Preschool

Creatinine
Cyclosporine
Female
Immunosuppressive Agents
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Recombinant Fusion Proteins
Population
Calcineurin Inhibitors
Delayed Graft Function
03 medical and health sciences
Young Adult
medicine
Humans
education
Mexico
Dialysis
Aged
Antilymphocyte Serum
Retrospective Studies
Immunosuppression Therapy
Transplantation
Thymoglobulin
business.industry
medicine.disease
Kidney Transplantation
Surgery
business
Zdroj: Transplantation proceedings. 48(2)
ISSN: 1873-2623
Popis: Background Induction therapy reduces the frequency of acute rejection and delayed graft function in renal transplantation. Basiliximab and Thymoglobulin are most commonly used agents for induction. Methods A retrospective study of two transplant centers in Veracruz, Mexico compared induction therapy in deceased donor renal transplantation from 2003 to 2014. Efficacy and safety outcomes evaluated were primary graft nonfunction, delayed graft function, acute rejection episodes and hospitalizations during first year, and patient and graft survival. P Results Seventy deceased kidney donors (40 male) were studied. Mean donor age was 32.9 ± 14.3 years, mean donor BMI 25.6 ± 4.3 kg/m2, and mean donor creatinine 1.13 ± 0.58 mg/dL. Main cause of death was trauma (62.9%). In total, 125 kidney transplantations were performed, with female predominance (53.6%) and mean age 33.8 ± 11.8 years. Of these, 66.4% used basiliximab and 33.6% Thymoglobulin. Thymoglobulin patients were significantly older, with lower weight and BMI, and were on dialysis longer than basiliximab patients. DGF was present in 19.3% of basiliximab patients vs 16.7% in Thymoglobulin patients, acute rejection occurred in 16.9% of basiliximab patients vs 19% Thymoglobulin patients. A total of 33.7% basiliximab patients were hospitalized during the first year vs 47.6% Thymoglobulin-induced patients (P > .05). Mean graft survival was 84.2 ± 5.3 months (73.8–94.7) basiliximab vs 32.4 ± 28.7 months (28.7–36.1) Thymoglobulin, Kaplan-Meier survival did not show statistically significant differences between groups (P = .276; CI 95%). Conclusion Similar transplant outcomes were obtained using basiliximab or Thymoglobulin induction in our population.
Databáze: OpenAIRE