Patterns of administration of antibody induction therapy and their associated outcomes.
1. There was a dramatic shift in the type of induction therapy used between 1996-2000. In 2000, more than half of recipients received induction therapy. 2. The type of transplants strongly influenced the use of antibody induction. LD recipients were least likely to receive antibody induction followed by unsensitized, sensitized cadaveric and SPK recipients. 3. Pan-T antibody induction was used more frequently in patients with DGF and in high immunologic risk groups. 4. IL-2 receptor antagonists have become the dominant induction therapy; even for recipients with high immunologic risk or those with DGF. 5. We cannot demonstrate the effects of pan-T antibody induction on the resolution of DGF. Pan-T antibody induction did not improve graft survival in any cohorts, although it was associated with lower acute rejection rates in LD and unsensitized groups. 6. IL-2R antibody induction therapy was associated with lower acute rejection and graft failure at one year in LD and unsensitized groups. However, this trend cannot be demonstrated in higher immunologic risk groups ie., sensitized cadaveric and SPK.
Bunnapradist
Suphamai
S
Kidney-Pancreas Transplant Program, Cedars Sinai Medical Center, Los Angeles, California, USA.
Daswani
Adarsh
A
Takemoto
Steven K
SK
D000293:Adolescent; D000328:Adult; D000917:Antibody Formation / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004231:Diuresis; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality / Q000502:physiology; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
D007166:Immunosuppressive Agents