Evidence of Interleukin-2-Receptor-Antibody Induction in Low-Risk Living Donor Kidney Transplantation: A Single-Center Pilot Study
| Autor: | Max Seidl, Johanna Schneider, Przemyslaw Pisarski, Oliver Thomusch, Torben Glatz, Bernd Jänigen, Stefan Zschiedrich, Stefan Fichtner-Feigl, Eric Peter Prager, Susanne Gehrmann |
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| Rok vydání: | 2019 |
| Předmět: |
Interleukin 2
Adult Graft Rejection Male medicine.medical_specialty chemical and pharmacologic phenomena Pilot Projects Mycophenolate Single Center Gastroenterology Tacrolimus Basiliximab Maintenance therapy immune system diseases Internal medicine Living Donors Medicine Humans Kidney transplantation Transplantation biology business.industry Graft Survival Induction Chemotherapy Middle Aged medicine.disease Kidney Transplantation stomatognathic diseases biology.protein Surgery Female Antibody business Immunosuppressive Agents medicine.drug |
| Zdroj: | Transplantation proceedings. 52(3) |
| ISSN: | 1873-2623 |
| Popis: | Background The recommended standard immunosuppressive therapy for renal transplant recipients comprises an initial induction therapy mainly with an interleukin-2-receptor antibody (IL2-RA) and a triple maintenance therapy. With tacrolimus and mycophenolate acid it is unknown whether IL2-RA application affects the short- and long-term results. This question is addressed in the present analysis. Methods From July 2007 to June 2019 a total of 127 living donor kidney transplant recipients meeting the center-specific definition of immunologic low risk situation (first transplantation, HLA-mismatch ≤3, panel reactive antibody ≤10%) were identified. In 83 recipients with a first-degree relationship to the donor we omitted the IL2-RA induction (IL2-RA-). The remaining 44 recipients, mostly not first-degree relatives, served as controls (IL2-RA+). Biopsy-proven acute rejection and long-term patient and graft survival rates were compared. Results Biopsy-proven acute rejection rates after 3 months were similar in both groups with 4.8% (IL2-RA-) vs 13.7% (IL2-RA+; P = .0937), including borderline rejection rates of 18.0% (IL2-RA-) vs 18.3% (IL2-RA+; P = 1.000), respectively. Ten-year long-term survival rates were comparable between the IL2-RA- and the IL2-RA+ group with 95.6% vs 93.5% (patient survival; P = .5465) and 92.1% vs 90.6% (death-censored graft survival; P = .8893). Conclusion For low-risk living donor kidney transplant recipients with first-degree relationship to the donor, it is safe to omit induction therapy with IL2-RA. |
| Databáze: | OpenAIRE |
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