Age Stratified Efficacy and Safety Outcomes of Induction Immunosuppression in Renal Transplantation
1Solid Organ Transplant, Yale New Haven Hospital, New Haven, CT
2University of St. Joseph School of Pharmacy, West Hartford, CT
3University of Connecticut School of Pharmacy, Storrs, CT.
Meeting: 2018 American Transplant Congress
Abstract number: B153
Keywords: Age factors, Induction therapy, Kidney transplantation, Outcome
Session Information
Session Name: Poster Session B: Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Purpose: Rejection and infection remain a leading concern for decreased graft survival after renal transplant (RT). Induction immunosuppression is associated with a decreased risk of biopsy proven acute rejection (BPAR). However, known prolonged lymphocyte and leukocyte depleting effects of alemtuzumab (AL) and anti-thymocyte globulin (rATG) are concerning limitations for use in vulnerable patient populations including the elderly. The aim of our study was to compare safety and efficacy outcomes of induction immunosuppression in RT recipients aged <45 years, 45-54 years, 55-64 years, and ≥65 years.
Methods: This was a retrospective, single center, chart review of RT recipients between 7/1/14 and 8/31/16. Patients were excluded for age <18 years, multi-organ transplant, or incomplete medical record at 12 months of follow up. The primary outcome was rate of BPAR at 12 months between patients receiving AL, rATG or basiliximab (BAS) for patients aged <45 years (G1), 45-54 years (G2), 55-64 years (G3), and ≥65 years (G4). Secondary outcomes included patient survival and infection rate between induction agents within these age groups.
Results: We included 219 patients during the study period (AL, n=126; rATG, n=73; BAS, n=20). Rate of BPAR differed significantly only between rATG and AL in G2 (8.2% vs. 0.8%, p<0.05). In G1, rATG had higher rates of cytomegalovirus (CMV) in comparison to AL (p<0.05). In G2, rATG had higher rates of CMV in comparison to AL and BAS as well as higher rates of urinary tract infection compared to AL (p<0.05). In G3, BAS had higher rates of BK virus compared to rATG (p<0.05). In G4, AL had higher rates of CMV compared to rATG and BAS (p<0.05). Patient survival did not differ significantly between groups.
Conclusion: Rate of BPAR at 12 months was significantly higher with rATG induction immunosuppression in comparison to AL in patients aged 45 to 54 years.
CITATION INFORMATION: McKimmy D., Kuzaro H., Sakya S., Belfield K., Cohen E. Age Stratified Efficacy and Safety Outcomes of Induction Immunosuppression in Renal Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
McKimmy D, Kuzaro H, Sakya S, Belfield K, Cohen E. Age Stratified Efficacy and Safety Outcomes of Induction Immunosuppression in Renal Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/age-stratified-efficacy-and-safety-outcomes-of-induction-immunosuppression-in-renal-transplantation/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress