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Anti-T Lymphocyte Immunoglobulins versus Basiliximab in Highly Sensitized Kidney-Transplant Patients without Preformed DSAs: The Satir Study

N. Kamar1, L. Couzi2, L. Albano3, A. Durrbach4, V. Pernin5, L. Esposito1, M. Lequintrec5, P. Merville2, A. Del Bello1

1Toulouse University Hospital, Toulouse, France, 2Bordeaux University Hospital, Bordeaux, France, 3Nice University Hospital, Nice, France, 4Henri Mondor University Hospital, Paris, France, 5Montpellier University Hospital, Montpellier, France

Meeting: 2020 American Transplant Congress

Abstract number: C-002

Keywords: Highly-sensitized, Induction therapy, Polyclonal, Rejection

Session Information

Session Name: Poster Session C: Kidney Immunosuppression: Induction Therapy

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Two prospective studies that were performed before the era of highly sensitive solid-phase assays have shown a lower incidence of acute rejection in highly sensitized kidney-transplant patients given polyclonal antibodies compared to those given anti-CD25 monoclonal antibodies. The aim of this prospective pilot randomized French multicenter study was to compare anti-T lymphocyte immunoglobulin (ATLG) and basiliximab in highly sensitized kidney-transplant patients.

*Methods: Highly sensitized kidney-transplant patients without preformed donor specific antibodies (pDSAs) as assessed by a Luminex Single Antigen flow bead assay were given ATLG (n=32) or basiliximab (n=27) Only patients with a cPRA ≥ 50%, with at least one antibody with a mean fluorescence intensity ≥ 5000 and without a historical pDSA and without a pDSA on the day of transplantation were included.

*Results: Treatment failure as defined by biopsy-proven acute rejection, patient lost to follow-up, graft loss and death was observed in 18.7% (95%CI=[8.9%-37%]) and 23.8% [11.9%-44.4%] in patients who received ATLG and 29.6% [16.1%-50.6%] and 36% [20.1%-58.9%] of patients who received basiliximab, respectively at 6 (p=0.4) and 12 (p=0.4) months post-transplantation. One T-cell mediated rejection and one borderline rejection were observed in ATLG-treated patients (6.3%). One antibody-mediated rejection and 4 borderline rejections occurred in basiliximab-treated patients (18.5%). Only one patient who received basiliximab developed a de novo DSA. Patient survival, graft survival, kidney function, histological lesions observed on protocol kidney biopsy, infection rate, and immunosuppressant tolerance were similar in the two groups.

*Conclusions: In conclusion, this pilot study indicates that in highly-sensitized kidney-transplant patients without pDSAs, both ATLG and basiliximab can be used efficiently and safely.

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To cite this abstract in AMA style:

Kamar N, Couzi L, Albano L, Durrbach A, Pernin V, Esposito L, Lequintrec M, Merville P, Bello ADel. Anti-T Lymphocyte Immunoglobulins versus Basiliximab in Highly Sensitized Kidney-Transplant Patients without Preformed DSAs: The Satir Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/anti-t-lymphocyte-immunoglobulins-versus-basiliximab-in-highly-sensitized-kidney-transplant-patients-without-preformed-dsas-the-satir-study/. Accessed May 9, 2025.

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