Efficacy and Safety of Induction Therapy With Monoclonal Versus Polyclonal Antibodies in Kidney Transplant Recipients in the Last Five Years (2008-2013) in Our Institution
Nephrology, La Paz Hospital, Madrid, Spain.
Meeting: 2015 American Transplant Congress
Abstract number: A152
Keywords: Antilymphocyte antibodies, Immunosuppression, Rejection, Simulect
Session Information
Session Name: Poster Session A: Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Induction immunosuppression in renal transplantation is not clearly defined. We analyze the efficacy and safety of the used regimens at our institution in the last five years.
We collected data from medical reports of transplanted patients(cadaveric and non-hyperimmunized)(n=160).
The treatment schemes were:
-Basiliximab, initial tacrolimus, steroids and mycophenolate mofetil(MMF).
-Thymoglobulin, delayed tacrolimus, steroids and MMF.
-ATEGE-Fresenius, delayed tacrolimus, steroids and MMF.
As efficacy variables: biopsy proven acute rejection, DGF(hemodyalisis needed in the first postransplant week), surgical complications, renal function at 6 months and graft loss.
As safety variables: posttransplant diabetes mellitus, cytomegalovirus and polyomavirus replication, posttransplant malignancies, severe bacterial infections, significant leucopenia and exitus.
The differences between patients´characteristics and analyzed variables are:
| Basiliximab(N=31) | Thymoglobulin(N=90) | ATEGE(N=33) | p | |
| Recipient age(x±sd) | 55,08±14,16 | 56,05±12,12a | 50,65±15,54a | a.p=0,04 |
| Donor age(x±sd) | 51,13±14,12 | 53,58±13,67a | 46,94±17,47a | a.p=0,05 |
| Cold ischemia(hours)(x±sd) | 13,79±3,95a | 15,2±4,19 | 16±4,5a | a.p=0,04 |
| Dose/Kg(x±sd) | – | 3,52±1,39 | 10,02±4,06 | p=0,00 |
| Results | Basiliximab(N=31) | Thymoglobulin(N=90) | ATEGE(N=33) | p |
| Hospital stay(days)(x±sd) | 15,74±16,08a | 16,43±18,19b | 24,85±19,71ab | a.p=0,04 b.p=0,02 |
| DGF N(%) | 14(45,2%) | 39(43,3%)a | 21(63,6%)a | a.p=0,04 |
| Acute rejection N(%) | 3(9,7%) | 5(5,6%) | 3(9,7%) | NS |
| CMV replication N(%) | 5(18,5%) | 27(30,3%)a | 4(12,1%)a | a.p=0,04 |
| Polyoma replication N(%) | 2(7,4%) | 19(21,3%) | 4(12,5%) | NS |
| Leukopenia N(%) | 8(29,6%) | 44(49,4%) | 15(45,5%) | NS |
| MDRD6th month(x±sd) | 52,58±14,85a | 44,04±16,67a | 47,9±15,57 | a.p=0,02 |
In terms of efficacy, Thymoglobulin-treated group showed a lower rate of acute rejection(no statistical significance) and ATEGE-Fresenius-treated group had higher DGF rate associated with a longer hospital stay(with statistical significance).
As for safety variables, Thymoglobulin-treated group had higher rate of CMV and polyomavirus replication(CMV replication with statistical significance). Those patients treated with Thymoglobulin or ATEGE-Fresenius had a severe grade of leukopenia(not statistical significant).
These data suggest that Thymoglobulin has higher immunossuppresive potency than Basiliximab and ATEGE-Fresenius.
To cite this abstract in AMA style:
Fernández M, López M, Ferreira M, Aguilar A, Jiménez C, Selgas R. Efficacy and Safety of Induction Therapy With Monoclonal Versus Polyclonal Antibodies in Kidney Transplant Recipients in the Last Five Years (2008-2013) in Our Institution [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/efficacy-and-safety-of-induction-therapy-with-monoclonal-versus-polyclonal-antibodies-in-kidney-transplant-recipients-in-the-last-five-years-2008-2013-in-our-institution/. Accessed May 19, 2025.« Back to 2015 American Transplant Congress