Multivariate analysis of antibody induction therapy and their associated outcomes in live donor kidney transplantation in the recent era

Sina Emami, Edmund Huang, Hung Tien Kuo, Mohammad Kamgar, Suphamai Bunnapradist

Research output: Contribution to journalArticlepeer-review

Abstract

The majority of kidney transplant recipients in the United States receive antibody induction, but its impact on outcomes in living donor transplant is not well-described. We used Organ Procurement and Transplant Network/United Network for Organ Sharing (OPTN/UNOS) data as of November 2009 to compare acute rejection (AR) and graft survival among all primary adult living donor kidney recipients of no antibody induction, antithymocyte globulin (ATG) and interleukin-2 receptor antagonists (IL-2RA) in an earlier era (1998-2002; n=21919) and a later era (2003-2008, n=26837). The incidence of AR in the overall cohort decreased from 18.5% in 1998 to 8% in 2008. From 1998 to 2002, antibody induction was associated with a decreased risk of acute rejection at six months (RR 0.67, 95% CI 0.62-0.72) and oneyr (RR 0.71, 0.65-0.76), while in the recent era, induction was not associated with acute rejection at sixmonths (RR 0.97, 0.88-1.07) or oneyr (RR 1.01, 0.91-1.10). There was no difference in graft survival over fiveyr with antibody induction in either era. Although antibody induction was associated with a decreased risk of AR from 1998 to 2002, it was not associated with a decreased risk of acute rejection from 2003 to 2008, nor was it associated with a difference in graft survival in either era.

Original languageEnglish (US)
Pages (from-to)351-358
Number of pages8
JournalClinical Transplantation
Volume26
Issue number2
DOIs
StatePublished - Mar 1 2012

Keywords

  • Acute rejection
  • Antibody induction
  • Graft survival
  • Interleukin-2 receptor antagonist
  • Kidney transplantation
  • Thymoglobulin

ASJC Scopus subject areas

  • Transplantation

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