Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Purpose: To report one year outcomes from single center experience with a novel induction regimen using anti-thymocyte globulin ( ATG)(rabbit)rATG (3 mg/kg) in divided doses given on operative day zero and day one and basiliximab (20 mg) on day two, followed by steroid-free maintenance therapy for renal transplant candidates.
BACKGROUND: Induction therapy with low dose therapy has potential of reducing infectious complications of rATG based regimen while reducing the incidence of acute rejection.
METHODS: Retrospective review of 64 patients transplanted over a year using induction therapy utilizing rATG(3mg/kg) in divided doses given operative day zero and day one and basiliximab (20mg) given on day two. Initial steroid pulse therapy was followed by rapid taper to steroid free day five. We compared our experience five years prior using a basiliximab (low risk) or rATG (high risk) based regimen followed by low dose steroid maintenance. Chronic maintenance therapy included tacrolimus and mycophenolate mofetil/mycophenolic acid.
We compared length of stay, 3, 6 and 12 month creatinine,biopsy proven rejection episodes, and morbidity to a historical cohort of patients five years prior using traditional induction regimens.
RESULTS: The average length of stay was significantly shorter for induction therapy group compared to historical group (4.62 days vs. 6.16 days, p = 0.01). The creatinine was similar in both groups at 3, 6, and 12 months (p = 0.27; p = 0.58; p = 0.75). The biopsy proven rejection rate within one year was also similar 7.8% for the induction therapy group and 8% for the historical group(p = 0.71). There is a lower rate of graft failure (0/64) (0.0%) versus (4/144)(2.8%), p = 0.14, and death (0/64) (0.0%) versus (2/144) (1.4%), p = 0.30, in the thymoglobulin plus basiliximab group compared to our historical cohort.
CONCLUSION: An abbreviated combination of rATG and basiliximab was associated reduced length of stay, lower rates of graft failure and death but equivalent infectious complication rates and rejection episodes when compared to traditional induction therapy with IL-2 receptor blockers or rATG alone combined with steroid maintenance. Long term results are yet pending, but we believe this novel approach akin to combined chemotherapy will better attain the delicate balance
To cite this abstract in AMA style:Whittaker V, Halleran D, Narsipar S, Melancon J. Single Center Experience With the Use of an Abbreviated Anti-Thymocyte Globulin and Basiliximab Combination Protocol in Renal Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/single-center-experience-with-the-use-of-an-abbreviated-anti-thymocyte-globulin-and-basiliximab-combination-protocol-in-renal-transplantation/. Accessed June 19, 2021.
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