The need for using induction therapy in de novo non-HLA sensitized kidney-transplant patients receiving tacrolimus-based therapy is a matter of debate. The aims of this study were to assess the incidence of donor-specific antibodies (DSAs) and acute rejection in this setting.

All non-HLA sensitized de novo kidney-transplant patients who have received maintenance immunosuppression based on tacrolimus and mycophenolic acid with or without steroids, with or without induction therapy, and who had undergone a first kidney transplantation between Mars 2008 to June 2015 were included in the study (n=450). 325 patients had received induction therapy (281 with basiliximab, and 44 with polyclonal antibodies). The remaining patients did not receive induction therapy (n=125). During the first year posttransplant, the incidence of acute rejection was 10.2% (44 out of 450 patients). Acute rejection episodes occurred in 38 patients who had been given induction therapy (11.7%) and 8 patients who have not be offered induction therapy (6.4%), p=ns. During the first year post-transplant, 9 patients who received induction developed at least one DSA (2.8%) versus none in the group without induction therapy (p=ns). Estimated glomerular filtration rate did not differ between both groups.

In conclusion, induction therapy is not required in low-immunological risk patients given tacrolimus and mycophenolic acid maintenance immunosuppression.

CITATION INFORMATION: Marion O, Del Bello A, Ferrandiz I, Esposito L, Congy N, Hebral A.-L, Kamar N. Incidence of Acute Rejection and Donor Specific Antibodies in Low-Immunological Risk Patients Treated by Tacrolimus and Mycophenolic Acid with or without Induction Therapy. Am J Transplant. 2017;17 (suppl 3).

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