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. 2024 Sep 12;17(9):sfae236.
doi: 10.1093/ckj/sfae236. eCollection 2024 Sep.

Basiliximab induction alone vs a dual ATG-basiliximab approach in first live-donor non-sensitized kidney transplant recipients with low HLA matching

Tammy Hod  1   2 , Shmuel Levinger  2 , Enosh Askenasy  1   2 , Maya Siman-Tov  3 , Yana Davidov  2   4 , Ronen Ghinea  1   2   5 , Niv Pencovich  1   2   5 , Ido Nachmani  2   5 , Eytan Mor  1   2   5
Affiliations

Basiliximab induction alone vs a dual ATG-basiliximab approach in first live-donor non-sensitized kidney transplant recipients with low HLA matching

Tammy Hod et al. Clin Kidney J. .

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Clin Kidney J. 2024 Nov 20;17(11):sfae344. doi: 10.1093/ckj/sfae344. eCollection 2024 Nov. Clin Kidney J. 2024. PMID: 39569315 Free PMC article.

Abstract

Background: Individualizing induction therapy based on immunological risk is crucial for optimizing outcomes in kidney transplantation.

Methods: A retrospective analysis included 157 first live-donor non-sensitized kidney transplant recipients (KTRs). Within this cohort, 96 individuals exhibited low human leukocyte antigen (HLA) matching (5-6 HLA mismatches). The low HLA match subgroup was categorized into 52 KTRs receiving basiliximab alone and 44 recipients treated with a combined single ATG dose of 1.5 mg/kg and basiliximab. The primary endpoint was early acute cellular rejection (ACR) within 6 months post-transplant while secondary outcomes encompassed infection rates, renal allograft function, length of stay (LOS) and readmissions post-transplant.

Results: The incidence of early ACR was decreased for low HLA match KTRs, who received ATG-basiliximab, when compared with low HLA-matched KTRs who received basiliximab alone (9.1% vs 23.9%, P = .067). Age was a predictor for rejection, and subgroup analysis showed consistent rejection reduction across age groups. No significant differences were observed in admission for transplant LOS or in peri-operative complications, nor in infections rate including BK and cytomegalovirus viremia, allograft function and number of readmissions post-transplant up to 6 months post-transplant.

Conclusion: In non-sensitized first live-donor KTRs with low HLA matching, a dual ATG-basiliximab induction approach significantly reduced early ACR without compromising safety.

Keywords: HLA match; anti-thymocyte globulin (ATG); basiliximab; induction treatment; kidney transplantation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1:
Figure 1:
CONSORT diagram.
Figure 2:
Figure 2:
(A) Early ACR rates in non-sensitized KTRs with first kidney transplants, contrasting high HLA match KTRs with basiliximab and low HLA matches KTRs with basiliximab and ATG–basiliximab induction. (B) Early ACR rates in low HLA match KTRs receiving basiliximab alone vs ATG–basiliximab induction across age categories.
Figure 3:
Figure 3:
(A) Admission for transplant LOS in low HLA match KTRs with basiliximab vs ATG–basiliximab induction. (B) Infections rate up to 6 months post-transplant in low HLA match KTRs with basiliximab vs ATG–basiliximab induction.
Figure 4:
Figure 4:
Early ACR rates in non-sensitized KTRs with first kidney transplants across age categories.
See this image and copyright information in PMC

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References

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