Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Due to the shortage in organs, ABO incompatible (ABOi) living-donor kidney transplantation (LDKT) was developed. Herein, we report on our single center experience and assess the impact of the type of induction therapy on the acute rejection rate.
Between March 2011 and December 2015, 54 ABOi LDKT were performed in our center: 44 ABOi and 10 ABOi and HLAi. All patients were treated with pretransplant apheresis and rituximab aiming an isoagglutinin titer (by tube dilution) < [frac14]. Until 01/2014, patients were given induction therapy with Thymoglobulin (n=27) and afterwards they were given basiliximab (n=27). Maintenance immunosuppression was based on tacrolimus, mycophenolic acid and steroids. The mean follow-up was 699±514 days.
Patients' survival was 100%. Grafts' survival was 92.5%. Graft losses were due to vein thrombosis at day 1 (n=1), relapse of the initial disease (n=1) and antibody-mediated rejection (ABMR, n=2). The acute rejection rate was 33%: ABMR (14.8%), TCMR (14.8%), and both ABMR and TCMR (3.7%). TCMR occurred significantly more frequently in patients given basiliximab (51%) compared to those who received Thymoglobulin (11%), p= 0.003. At one-year kidney function MDRD GFR was 54.3±19.8 mL/min. It was significantly worse in patients who had experienced an acute rejection episode. No difference in grafts' survival, kidney function and acute rejection rate was observed between ABOi and ABOi HLAi LDKT patients. Bacterial infections, CMV replication and BKV replication were observed in 55%, 48.1% and 31.5% of patients, respectively. Only CMV replication rate was significantly lower in patients given basiliximab compared to Thymoglobulin.
In conclusion, ABOi LDKT provides in the mid-term very good results. Thymoglobulin induction therapy was associated with less acute rejection episodes.
CITATION INFORMATION: Lanfranco L, Esposito L, Del Bello A, Cointault O, Allal A, Rostaing L, Kamar N. Effect of Induction Therapy in ABO Incompatible Living-Donor Kidney Transplantation: A Single Center Experience. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Lanfranco L, Esposito L, Bello ADel, Cointault O, Allal A, Rostaing L, Kamar N. Effect of Induction Therapy in ABO Incompatible Living-Donor Kidney Transplantation: A Single Center Experience. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-induction-therapy-in-abo-incompatible-living-donor-kidney-transplantation-a-single-center-experience/. Accessed January 21, 2020.
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