Impact of Induction Therapy on Cardiovascular Events in Kidney Transplant Recipients.

S. Sandal,^1,2 S. Bae,² A. Massie,² M. Cantarovich,¹ D. Segev.²

¹MUHC, Montreal, Canada
²JHU, Baltimore.

Meeting: 2016 American Transplant Congress

Abstract number: 11

Keywords: Heart, Induction therapy, Kidney transplantation, T cells

Session Information

Session Name: Concurrent Session: Cardiovascular Complications in Kidney Transplantation

Session Type: Concurrent Session

Date: Sunday, June 12, 2016

Session Time: 2:30pm-4:00pm

Presentation Time: 3:30pm-3:42pm

Location: Room 304

Cardiovascular events (CVE) are one of leading causes of mortality in kidney transplant (KT) recipients and ATG use is reported as a risk factor. We compared the impact of induction therapy on CVE post-KT: no induction, alemtuzumab, anti-thymocyte globulin (ATG) and IL-2 receptor antagonist (IL-2RA).

Methods: Medicare-primary KT recipients from 1999 -2010 were studied using USRDS data. The outcome of interest was time to first post-KT CVE hospitalization, ascertained using validated ICD-9 codes for myocardial infarction, congestive heart failure, stroke and transient ischemic attack. We used Cox regression to model the association between induction therapy and CVE, adjusting for recipient, donor and transplant characteristics.

Results: A total of 86,541 first-time KT recipients were eligible for analysis. Compared with the no induction group, ATG and IL2 were at a similar risk for CVE

Adjusted hazard of CVD-related readmission (Ref: No induction)
	Overall			LDKT only			DDKT only
	aHR	95%CI	p	aHR	95%CI	p	aHR	95%CI	p
IL-2 RA	0.97	0.92-1.02	0.2	1.03	0.93-1.14	0.6	0.96	0.90-1.01	0.1
ATG	0.96	0.91-1.02	0.2	1.01	0.89-1.14	0.9	0.96	0.90-1.01	0.1
Alemtuzumab	1.18	1.06-1.30	0.001	1.00	0.80-1.26	1.0	1.22	1.10-1.37	<0.001

. However, KT recipients who received alemtuzumab as induction therapy had 18% higher CVE. When stratified by donor type, this association was only found among recipients of kidneys from deceased donors (22% higher CVE).

Conclusion: Deceased donor recipients receiving alemtuzumab, particularly those with high baseline cardiovascular risk profile, should be closely monitored for CVE and/or should receive other induction agents.

CITATION INFORMATION: Sandal S, Bae S, Massie A, Cantarovich M, Segev D. Impact of Induction Therapy on Cardiovascular Events in Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Sandal S, Bae S, Massie A, Cantarovich M, Segev D. Impact of Induction Therapy on Cardiovascular Events in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-induction-therapy-on-cardiovascular-events-in-kidney-transplant-recipients/. Accessed November 22, 2024.

« Back to 2016 American Transplant Congress