Kidney graft outcomes in living-related transplantation have improved with substitution of basiliximab and mycophenolate mofetil for antithymocyte globulin and azathioprine: a single center retrospective cohort study.
BACKGROUND
Despite significant reduction in acute rejection rates and improvements in one year kidney allograft outcomes over the past decade, there is an overall lack of improvement in long-term allograft outcomes. We conducted this study to evaluate whether immunosuppressive regimens involving basiliximab and mycophenolate mofetil improved allograft outcomes in living-related kidney transplantation beyond the first year.


METHODS
In a retrospective cohort study we analyzed kidney graft survival, acute rejection-free survival, kidney function, delayed graft function, and primary non-function in patients receiving an immunosuppressive regimen that included basiliximab and mycophenolate mofetil (group A), and compared to patients receiving antithymocyte globulin and azathioprine (group B). The rest of the treatment protocols remained the same, including cyclosporine A and steroids in both groups.


RESULTS
Seven-year graft survival rates in groups A and B were 83% and 44%, respectively (p=0.005), 7-year acute rejection-free survival rates were 82% and 53%, respectively (p=0.03), kidney function was better (p=0.004) and its deterioration rate was lower (p=0.006) in patients receiving regimen A. In group A 1 primary non-function event was observed in contrast to 4 composite events of delayed graft function and primary non-function in group B (p>0.05).


CONCLUSIONS
Long-term graft outcomes in living-related kidney transplantation have improved with substitution of basiliximab and mycophenolate mofetil for antithymocyte globulin and azathioprine in immunosuppressive protocols.
University Clinical Center Tuzla, Department of Nephrology and Dialysis, Tuzla, Bosnia and Herzegovina. goran_imamovic@bin.net.ba
Goran
G
Imamović
Enver
E
Zerem
Enes
E
Osmanović
D000208:Acute Disease; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D001379:Azathioprine / Q000008:administration & dosage*; D000077552:Basiliximab; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D009173:Mycophenolic Acid; D001379:Azathioprine