*Purpose: Current dosing recommendations for the administration of basiliximab on post-operative days (POD) 0 and 4 stem from two phase 3 renal transplant studies. Limited studies have explored alternative dosing strategies and found no difference in the incidence of graft loss 12 months post-transplant. The purpose of this study is to compare outcomes of basiliximab for induction therapy on POD 0 and 4 versus POD 0 and 3 in kidney transplant recipients. The results from this study may confirm this alternative dosing strategy as equally effective to conventional dosing which may lead to a shorter length of stay post kidney transplant.

*Methods: A single center retrospective, observational chart review was performed in kidney transplant recipients who received basiliximab induction therapy between January 2017 and May 2019. The primary endpoint was to compare the incidence of biopsy-proven rejection (BPR) rates at 1, 3, and 6 months post-transplant. Secondary endpoints included six month graft and patient survival, mean tacrolimus levels, and length of stay. Patients were excluded if they did not have documentation of basiliximab administration, were lost to follow-up, or had medication non-compliance.

*Results: A total of 91 patients were included in this study: 45 received basiliximab on POD 0 and 3, 46 received basiliximab on POD 0 and 4. There was no significant difference in BPR at 1 month (9 v 7%, p=0.713), 3 months (13 v 17%, p=0.773), and 6 months (16 v 20%, p=0.784) between patients receiving basiliximab on POD 0 and 3 versus POD 0 and 4. There was no difference in mean tacrolimus levels at 6 months between the two groups (9.2 ± 1.2 v 9.6 ± 2.0, p=0.327). Overall graft and patient survival was similar between groups with one death in the POD 0 and 3 group due to an unknown cause several days after initial discharge. Length of stay was not statistically significant between the groups, but the trend was shorter for the POD 0 and 3 group compared to POD 0 and 4 (5.2 ± 2.1 v 5.9 ± 2.1 days, p=0.051).

*Conclusions: In this retrospective chart review, we found that BPR rates were similar between the two groups up to 6 months after kidney transplantation as well as graft and patient survival. Length of stay was numerically shorter with basiliximab administration POD 0 and 3 compared to POD 0 and 4. From our institutional results, administering basiliximab on POD 0 and 3 is as efficacious and can lead to shorter length of stay in our kidney transplant patients.

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