Background: The effectiveness and safety of induction with basiliximab (IL2RA) in sensitized kidney transplant recipients is not clearly established. The aim of this study was to assess the impact of induction with IL2RA on graft and safety outcomes in sensitized patients.

Methods: Single center retrospective cohort study of adult kidney transplant recipients who received induction with IL2RA between 08/2011 and 12/2013. Patients were considered sensitized if their cPRA>20%. Maintenance therapy included a tacrolimus-based triple immunosuppressant regimen that was consistent throughout the entire time period.

Results: 217 patients were included in the study. Baseline patient and graft characteristics were similar between the groups, though patients with cPRA>20% were more likely to be female or black (Table 1). There were no significant differences in median tacrolimus levels between the groups at any time from post-transplant day 3 to 180. While there were no significant differences in CIT, deceased donors, or ECD between groups, patients with cPRA≤20% were more likely to experience DGF compared to sensitized patients. There were no significant differences in rejection (10.5% vs 2%; P=0.360) or graft loss (7.7% vs 2.7%; P=0.284) between patients receiving induction with IL2RA based on cPRA, which remained constant after controlling for confounders (race, CIT, ECD, DGF). There were no significant differences in safety outcomes between groups (Figure 1).

Conclusions: IL2RA induction therapy was an effective and safe induction agent in sensitized adult kidney transplant recipients. Increasing cPRA was not associated with any increased risks including rejection in patients who received IL2RA.

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