title: Survival benefit of induction immunosuppression in cystic fibrosis lung transplant recipients.
abstract: BACKGROUND
  Despite resistant microbes, induction immunosuppression is used in patients with cystic fibrosis (CF) undergoing lung transplantation (LTx).
  
  
  METHODS
  To evaluate the effect of induction immunosuppression on survival, the United Network for Organ Sharing (UNOS) was queried restricting analysis to transplant patients 6-55years old from 2001 to 2012, who received induction agents (INDUCED) or did not (NONE).
  
  
  RESULTS
  A total of 1721 CF patients who underwent LTx were included in the analysis; of these 791 (46%) were INDUCED. Of the INDUCED patients, 65% received basiliximab, 10% alemtuzumab, and 25% thymoglobulin/anti-lymphocyte globulin/anti-thymocyte globulin. Mean age was 28.0years (SD=9.7) and 28.5 (SD=9.5) for the INDUCED and NONE groups, respectively. The median survival in the INDUCED group was 93.8months (95% CI: 73.8, --) compared to 61.8months (95% CI: 55.8-73.8) for the NONE group (log rank p-value <0.001).
  
  
  CONCLUSIONS
  Antibody-based induction immunosuppression had a survival benefit in CF patients undergoing LTx.
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, OH, USA; Department of Internal Medicine, The Ohio State University, Columbus, OH, USA; Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: stephen.kirkby@nationwidechildrens.org.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kirkby
authors.affiliation: Department of Surgery, The Ohio State University, Columbus, OH, USA.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Whitson
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Wehr
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Lehman
authors.affiliation: Department of Surgery, The Ohio State University, Columbus, OH, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Higgins
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, OH, USA; Department of Internal Medicine, The Ohio State University, Columbus, OH, USA; Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Hayes
mesh_terms: D000293:Adolescent; D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D000077552:Basiliximab; D002648:Child; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D066027:Transplant Recipients / Q000706:statistics & numerical data; D014181:Transplantation Immunology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000074323:Alemtuzumab; D000077552:Basiliximab; C512542:thymoglobulin
keywords: Cystic fibrosis; Immunosuppression; Induction; Lung transplantation; Survival