The choice of induction therapy in elderly renal transplant population is generally based on experience from general renal transplant recipient (RTR) population. It is uncertain which induction therapy is more efficacious or safer in elderly.

We reviewed retrospectively medical records of patients who were ≥60 years of age and received a kidney transplant and recieved induction therapy with either Thymoglobulin (ATG) or Interleukin 2 Receptor antagonist (IL2RA) from 1/2004 through 12/2011. Data were collected for 12 months post transplant. Categorical variables were summarized with counts and percentages and compared between groups with chi square test and a t test was performed when continuous data, expressed with mean and standard deviation was compared between two groups. Primary outcomes were acute rejection rate and renal function at 30 days and 12 months.

Results: 127 of RTR received ATG and 95 received IL2RA. Acute rejection within one year post transplant was 19.77% in the IL2R group and 13.04% in the ATG group (P=0.19). Of the 9 in the ATG group who died, 5 had functional graft. Of the 4 patients in the IL2RA group who died, 2 had functional graft. Among the deceased donor RTR, the mean serum creatinine at 12 months was significantly higher in the ATG group (1.8±1.3 mg/dl) compared to IL2RA group (1.5±0.55 mg/dl) ;P <0.03. No significant difference was found in serum creatinine at 30 days. Delayed graft function defined as requiring dialysis within one week of transplant, occurred among 33.1% of deceased donor RTR in ATG group and 28.3% of deceased donor RTR in IL2RA group, (P value 0.5539).

Conclusion: In RTR ≥60 years, acute rejection rates were comparable between the two groups. Mortality was higher in ATG group. 12 month serum creatinine was better in the IL2RA group. Data about infections, cytopenias and readmissions is to be analyzed.

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