Role of Induction Therapy in Low Immune Risk Kidney Transplant Recipients: A Mate Kidney Analysis.
Nephrology, Internal Medicine, Allegheny General Hospital, Pittsburgh, PA
Meeting: 2017 American Transplant Congress
Abstract number: B179
Keywords: Immunosuppression
Session Information
Session Name: Poster Session B: Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
In the current era of powerful maintenance immunosuppression, it is unclear whether induction therapy positively adds to the outcomes in low immune risk kidney transplant recipients (KTRs).
Using OPTN/UNOS database, we identified adult low immune risk (1st transplant, PRA<20% & HLA mismatch≤ 3) deceased donor KTRs from 2004 to 2014 who were discharged on tacrolimus/MMF maintenance. Using a mate kidney model, three groups were further identified as follows: group 1: no induction (n=96) vs. IL-2 receptor antibody (IL-2RA, n=96); group 2: no induction (n=181) vs. depleting antibody (Thymoglobulin or alemtuzumab) (n=181); group 3: IL-2RA (n=240) vs. depleting antibody (n=240).
Demographic features were similar between mate kidney recipients except for more previous malignancy in no induction vs. depleting induction in group 2 and IL-2RA vs. depleting induction in group 3. More patients were discharged on steroids in IL-2RA induced patients in group 1 (99% vs. 83%, p<0.001) and depleting antibody induced patients in group 2 (94% vs. 82%, p <0.001). Outcomes are shown in table. Adjusted risk for 1-year rejection, 5-year graft failure and patient death were similar between mate kidney recipients.
| Group 1 | Group 2 | Group 3 | ||||
| Outcomes | No induction | IL-2RA | No induction | Depleting | IL-2RA | Depleting |
| Delayed graft function% | 17 | 12 | 17 | 28* | 23 | 17 |
| Adjusted OR with 95% CI | Control | 0.60
(0.24-1.45) |
Control | 1.89*
(1.09-3.25) |
Control | 0.74
(0.46-1.18) |
| 1-year rejection% | 10 | 9.4 | 12 | 6.1 | 13 | 9.2 |
| Adjusted OR with 95% CI | Control | 0.77
(0.25-2.33) |
Control | 0.53
(0.25-1.11) |
Control | 0.63
(0.35-1.11) |
| 5-year graft survival % | 64 | 68 | 56 | 66 | 61 | 73* |
| Adjusted HR with 95% CI[dagger] | Control | 0.86
(0.49-1.49) |
Control | 0.73
(0.48-1.10) |
Control | 0.80
(0.54-1.17) |
| 5-year patient survival % | 72 | 72 | 68 | 73 | 65 | 77* |
| Adjusted HR with 95% CI[dagger] | Control | 0.84
(0.42-1.66) |
Control | 0.65
(0.41-1.05) |
Control | 0.74
(0.48-1.13) |
| *= p<0.05 vs. mate kidney group;[dagger]=graft failure/patient death risks | ||||||
Conclusion: Our findings in a mate kidney model suggests that antibody induction may not be needed in low immune risk KTRs discharged on tacrolimus/MMF with steroid and can reduce cost.
CITATION INFORMATION: Sampaio M, Sureshkumar K. Role of Induction Therapy in Low Immune Risk Kidney Transplant Recipients: A Mate Kidney Analysis. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Sampaio M, Sureshkumar K. Role of Induction Therapy in Low Immune Risk Kidney Transplant Recipients: A Mate Kidney Analysis. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/role-of-induction-therapy-in-low-immune-risk-kidney-transplant-recipients-a-mate-kidney-analysis/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress