title: Induction therapy in simultaneous pancreas-kidney transplantation: thymoglobulin versus basiliximab.
abstract: BACKGROUND
  Induction therapy for simultaneous pancreas-kidney (SPK) transplantation. Both thymoglobulin (ATG) and basiliximab are the most-used types of induction antibodies therapies in clinical practice. The aim of our report was to analyze our experience comparing 2 induction therapies, for SPK transplantation in terms of pancreas and patient survival, as well as rejection rate.
  
  
  METHODS
  We reviewed retrospectively a total of 97 SPK transplantations in our institution. The cases were divided according to induction therapy in 2 groups, basiliximab (n = 38) and ATG (n = 59). Rejection, patient and graft survival, and postoperative complications were analyzed.
  
  
  RESULTS
  Survival in the ATG group was better without statistical difference at 1-, 3-, and 5-year follow-up (97%, 95%, and 95% versus 92%, 90%, and 87%, respectively). No difference was detected in pancreas graft survival after 1-, 3-, and 5-year follow-up (basiliximab 85%, 80%, and 77% versus ATG 84%, 84%, and 81%, respectively; log-rank, 0.847). Overall cellular rejection and early rejection were more common in the basiliximab group (30 versus 14%, and 21% versus 6%). In the multivariate analysis considering human leukocyte antigen (HLA) mismatches, the ATG group was a protective factor for cellular rejection. Major complications (Grade III-IV) and median length of the hospital stay were higher in the basiliximab group (55% versus 34%, P = .057, and 21 versus 16 days, P = .056).
  
  
  CONCLUSIONS
  The pancreas graft survival was not affected by induction therapy. ATG induction therapy compared with basiliximab is associated with lower overall and early rejection rate. Over time this difference disappears.
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain. Electronic address: isabel.fernandez.burgos@gmail.com.
authors: I
authors: I
authors: Fernández-Burgos
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: M C
authors: MC
authors: Montiel Casado
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: J A
authors: JA
authors: Pérez-Daga
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: J M
authors: JM
authors: Aranda-Narváez
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: B
authors: B
authors: Sánchez-Pérez
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: F J
authors: FJ
authors: León-Díaz
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: M
authors: M
authors: Cabello-Díaz
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: D
authors: D
authors: Rodríguez-Burgos
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: D
authors: D
authors: Hernández-Marrero
authors: Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors: J
authors: J
authors: Santoyo-Santoyo
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D000077552:Basiliximab; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D060828:Induction Chemotherapy / Q000379:methods*; D016030:Kidney Transplantation / Q000401:mortality*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016035:Pancreas Transplantation / Q000401:mortality*; D011183:Postoperative Complications / Q000453:epidemiology; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; C512542:thymoglobulin