We compare the 3-year outcomes of induction therapies with either methylprednisolone (group 1, n=58), basiliximab (group 2, n=56) or alemtuzumab (group 3, n=98) in primary deceased donor kidney transplants with delayed graft function (DGF). Maintenance was tacrolimus and mycophenolate with steroid (group 1 and 2) or without steroid (group 3). Three -year biopsy-confirmed acute rejection (AR) rates were 31%, 21.4% and 12.2% in group 1, 2 and 3 (p=0.01). AR was significantly lower in group 3 (p=0.007) and group 2 (p=0.04) than in group 1. Three-year graft survival rates were 86.2 %, 93% and 96.9 % in group 1, 2 and 3 (log rank p=0.01). Group 1 had inferior graft survival than group 2 (p=0.046) and group 3 (p=0.006). The 3-year patient survival rates were not statistically different (93.1%, 96.4% and 98%, log rank p=0.65). Multivariable analysis using methylprednisolone induction as control indicated that alemtuzumab (OR 0.43, 95% CI 0.26-0.71; p=0.01) and basiliximab (OR 0.66 , 95% CI 0.31-0.94 ; p=0.03) were associated with lower risk of AR. Therefore, our 3-year follow-up study for patients with DGF indicates that alemtuzumab or basiliximab induction decreases AR and improves graft survival than methylprednisolone alone. Alemtuzumab induction might also allow patients with DGF to be maintained with contemporary steroid-withdrawal protocol.

CITATION INFORMATION: Umber A, Killackey M, Paramesh A, Alper B, Teran F, Baudy A, Liu Y, Buell J, Zhang R. Three Induction Therapies on Patients with Delayed Graft Function After Kidney Transplantation, a Three-Year Outcome Analysis. Am J Transplant. 2017;17 (suppl 3).

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