Analysis of Rabbit Anti-Thymocyte Globulin versus Basiliximab Induction in Pediatric Liver Transplant Recipients
1Pharmacy, Seattle Children's Hospital, Seattle, WA
2Pediatrics, UW School of Medicine, Seattle, WA
3Seattle Children's Research Institute, Seattle.
Meeting: 2018 American Transplant Congress
Abstract number: B291
Keywords: Rejection
Session Information
Session Name: Poster Session B: Liver: Pediatrics
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: Literature is limited comparing rabbit anti-thymocyte globulin (rATG) versus basiliximab (BSX) induction in pediatric liver transplant (LT) recipients in the setting of modern-day maintenance immunosuppression.
Methods:
This was a single-center, retrospective cohort study of all primary pediatric LT recipients transplanted at our center who received either BSX (1/1/2005-2010) or rATG (2011-2016) induction. Patients were excluded if they received an ABO incompatible graft, were retransplanted, or were recipients of multiple organs. Maintenance immunosuppression consisted of tacrolimus with similar trough goals between groups and steroids. Primary outcomes of this study were incidence of biopsy-proven acute rejection (BPAR) and post-transplant lymphoproliferative disorder (PTLD) within the first year post-LT. Secondary outcomes included graft and patient survival, time to first BPAR episode, and incidence of steroid-resistant rejection (SRR) within the first year post-LT.
Results:
A total of 136 patients were included in the final analysis of which 57 patients (42%) received BSX induction. 61.4% and 64.5% were ≤ 5 years of age and 68.4% and 82.3% were transplanted due to chronic liver disease in the BSX and rATG groups, respectively. Patients receiving induction with rATG experienced significantly more BPAR than those receiving BSX (p=0.04). There were no significant differences in PTLD, graft or patient survival, grade of acute cellular rejection, time to first BPAR, or SRR between the two groups.
Table 1. Assessment of Outcomes
| Outcome | BSX (n=57) | rATG (n=79) | p-value |
| BPAR, n (%) | 23 (40.4) | 46 (58.2) | 0.04[dagger] |
| SRR, n (%) | 2 (3.5) | 7 (8.9) | 0.14[Dagger] |
| Time to first BPAR, median days (IQR) | 45 (124) | 25.5 (26) | 0.16* |
| Graft failure, n (%) | 3 (5.3) | 3 (3.8) | 0.69[Dagger] |
| Death, n (%) | 1 (1.8) | 1 (1.3) | 1.00[Dagger] |
| PTLD, n (%) | 2 (3.5) | 1 (1.3) | 0.57[Dagger] |
Note. [dagger]Chi-Square Test. [Dagger]Fisher's Exact Test. *Wilcoxon Rank Sum Test.
Conclusion: Induction with rATG resulted in significantly more BPAR in primary pediatric liver transplant recipients when compared to BSX in the setting of modern-day maintenance immunosuppression with tacrolimus and corticosteroids.
CITATION INFORMATION: Newland D., Royston M., McDonald D., Wallace-Boughter K., Németh T., Carlin K., Horslen S. Analysis of Rabbit Anti-Thymocyte Globulin versus Basiliximab Induction in Pediatric Liver Transplant Recipients Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Newland D, Royston M, McDonald D, Wallace-Boughter K, Németh T, Carlin K, Horslen S. Analysis of Rabbit Anti-Thymocyte Globulin versus Basiliximab Induction in Pediatric Liver Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/analysis-of-rabbit-anti-thymocyte-globulin-versus-basiliximab-induction-in-pediatric-liver-transplant-recipients/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress