Using Basiliximab Does Not Increase De Novo DSA Incidence but Reduces Cytomegalovirus Infections and Neoplastic Complications in Non-Sensitized Kidney Transplant Patients.
1Department of Nephrology, Dialysis and Transplantation, Hôpital Lapeyronie, Montpellier University Hospital, Montpellier, France
2Departement of Immunology, Hôpital Saint Eloi, Montpellier University Hospital, Montpellier, France
3Inserm U1183, IRMB, Hôpital Saint Eloi, Montpellier University Hospital, Montpellier, France
Meeting: 2017 American Transplant Congress
Abstract number: B190
Keywords: Alloantibodies, Antilymphocyte antibodies, Interleukin-2 receptor, Kidney transplantation
Session Information
Session Name: Poster Session B: Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background. In kidney transplantation, de novo donor specific antibodies (dnDSA) are associated with antibody-mediated rejection (AMR) and graft failure. After dnDSA development, 24% of the patients will fail within 3 years. Considering the deleterious effect of dnDSA on graft outcome and the lack of effective treatment of AMR, clinicians must avoid alloimmunization. As the influence of induction therapies on dnDSA generation, in low-immunological risk kidney transplant recipients, is unknown, we analysed its impact on dnDSA incidence in a cohort of non-sensitized patients.
Methods. Patients receiving, in our centre, a first kidney transplant between January 2008 and December 2014, and an induction therapy by ATG or basiliximab were eligible for the study. We excluded combined and ABO-incompatible transplantations and patients with pre-transplantation anti-HLA immunization. Pre-transplant immunization was defined as at least one anti-HLA antibody with mean fluorescence intensity superior at 500. Early graft failures, defined by primary graft dysfunction and vascular thrombosis arising during the first week after transplantation, have also been excluded.
Results. 303 kidney transplant recipients were included. Recipient age was 52.2 ± 14 years. 84 (27.7%) patients were treated with basiliximab and 219 (72.3%) patients with ATG with a mean dose of 375.75 ± 104 mg. Baseline demographics and characteristics were similar between the two groups. During the follow-up period (5.1 [3.0; 7.3] years), 44 (14.5%) patients developed dnDSA, 35 (16.0%) in the ATG group and 9 (10.7%) in the basiliximab group (Log-rank C2=0.32, p=0.57). Graft survival was 86% in the ATG group and 81% in the basiliximab group (p=0.38). There were significantly more cytomegalovirus infection (52% versus 33%, p=0,01) and neoplastic diseases (17% versus 7%, p=0,03) in the ATG group.
Conclusions. In patients with low immunological risk, induction with basiliximab is associated with a reduction of infectious and neoplastic complications occurrence compared to ATG induction, without increasing dnDSA development.
CITATION INFORMATION: Marron-Wojewodzki M, Szwarc I, Rene C, Eliaou J.-F, Mourad G, Le Quintrec M. Using Basiliximab Does Not Increase De Novo DSA Incidence but Reduces Cytomegalovirus Infections and Neoplastic Complications in Non-Sensitized Kidney Transplant Patients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Marron-Wojewodzki M, Szwarc I, Rene C, Eliaou J-F, Mourad G, Quintrec MLe. Using Basiliximab Does Not Increase De Novo DSA Incidence but Reduces Cytomegalovirus Infections and Neoplastic Complications in Non-Sensitized Kidney Transplant Patients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/using-basiliximab-does-not-increase-de-novo-dsa-incidence-but-reduces-cytomegalovirus-infections-and-neoplastic-complications-in-non-sensitized-kidney-transplant-patients/. Accessed May 9, 2025.« Back to 2017 American Transplant Congress