Induction therapy in pediatric kidney transplant recipients discharged with a triple drug immunosuppressive regimen
| Autor: | Marcelo S, Sampaio, Neda, Poommipanit, Hung-Tien, Kuo, Pavani N, Reddy, Yong W, Cho, Tariq, Shah, Suphamai, Bunnapradist |
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| Rok vydání: | 2010 |
| Předmět: |
Graft Rejection
Male Daclizumab Adolescent Recombinant Fusion Proteins Antibodies Monoclonal Infant Receptors Interleukin-2 Antibodies Monoclonal Humanized Kidney Transplantation Basiliximab Child Preschool Immunoglobulin G Odds Ratio Humans Immunologic Factors Kidney Failure Chronic Drug Therapy Combination Female Antibodies Blocking Child Immunosuppressive Agents Antilymphocyte Serum Retrospective Studies |
| Zdroj: | Pediatric transplantation. 14(6) |
| ISSN: | 1399-3046 |
| Popis: | We evaluated the effectiveness of induction therapy on transplant outcomes during 2004-2007 in the United States. We retrospectively reviewed OPTN/UNOS registry and selected kidney pediatric (21-yr) recipients that received no induction (NoIND), IL-2RA, or rabbit anti-THY and were discharged with a triple drug immunosuppressive maintenance regimen, including steroids. Of 2932 recipients, 20%, 36%, and 43% were in NoIND, THY, and IL-2RA groups, respectively. The majority received tacrolimus (88%) and MMF (89%) at discharge. There was no association of induction with the risk of acute rejection even after adjusting for known cofounders. Compared to NoIND, IL2-RA, but not THY, had a modest decrease (3%) in absolute rate of graft loss and was associated with a risk reduction ratio of 0.51 (95% CI, 0.31-0.84) in one-yr graft loss. At three yr, no induction agent was associated with decreased graft loss. In conclusion, induction agents were used in 80% of pediatric kidney recipients discharged with a triple drug immunosuppressive maintenance regimen between 2004-2007 in the United States. Neither THY nor IL-2RA was associated with reduced rejection episodes. The use of induction therapy was not associated with improvement in three-yr graft survival. |
| Databáze: | OpenAIRE |
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