Induction therapy with basiliximab versus Thymoglobulin in African-American kidney transplant recipients.
BACKGROUND
It has been suggested that the use of antilymphocyte induction therapy in African-American (AA) renal transplant recipients reduces the risk of acute rejection (AR) and improves graft survival. It is not clear whether the efficacy of basiliximab (BSX) is different from that of Thymoglobulin (ATG) in this regard.


METHODS
We retrospectively assessed the effect of induction therapy with BSX versus ATG in 88 AA renal allograft recipients receiving transplants at our center between July 2001 and June 2003 and followed for 19+/-7 months. All patients were maintained on mycophenolate mofetil, prednisone, and either tacrolimus or sirolimus. Study endpoints included patient and graft survival, graft function, and incidence of AR and cytomegalovirus infection. Regression models were used to evaluate the independent effect of each induction agent on these endpoints.


RESULTS
Thirty-six patients received ATG, and 52 received BSX. The groups were comparable with regard to donor race and age, and recipient sex, body mass index, human leukocyte antigen (HLA) matching, and hepatitis C virus serostatus. The ATG group was younger, more likely to receive retransplant, had longer duration of end-stage renal disease and higher panel reactive antibody, and was less likely to receive live-donor organs. However, after adjusting for all these variables, graft outcomes, as well as renal function, were comparable between the two induction groups. We found that the degree of HLA mismatch, delayed graft function, and AR were the only significant predictors of graft loss.


CONCLUSIONS
The results of our study suggest that the choice of induction agent may not have a major impact on graft outcomes in AA renal-allograft recipients.
Haririan
Abdolreza
A
Division of Nephrology, Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA. aharirian@med.wayne.edu
Morawski
Katherina
K
Sillix
Dale H
DH
El-Amm
Jose M
JM
Garnick
James
J
West
Miguel S
MS
Granger
Darla K
DK
Migdal
Stephen D
SD
Gruber
Scott A
SA
D000328:Adult; D001741:Black or African American; D000911:Antibodies, Monoclonal / Q000276:immunology* / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000276:immunology* / Q000627:therapeutic use; D000077552:Basiliximab; D003401:Creatine / Q000097:blood; D005260:Female; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D007167:Immunotherapy; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011993:Recombinant Fusion Proteins / Q000276:immunology* / Q000627:therapeutic use; D012189:Retrospective Studies; D014180:Transplantation; D014184:Transplantation, Homologous / Q000276:immunology
D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D003401:Creatine