Induction Immunosuppressive Therapy Use in Deceased Donor Kidney Transplantation: 11-Year Experience in Veracruz, Mexico.
BACKGROUND
Induction therapy reduces the frequency of acute rejection and delayed graft function in renal transplantation. Basiliximab and Thymoglobulin are most commonly used agents for induction.


METHODS
A retrospective study of two transplant centers in Veracruz, Mexico compared induction therapy in deceased donor renal transplantation from 2003 to 2014. Efficacy and safety outcomes evaluated were primary graft nonfunction, delayed graft function, acute rejection episodes and hospitalizations during first year, and patient and graft survival. P < .05 was considered statistically significant.


RESULTS
Seventy deceased kidney donors (40 male) were studied. Mean donor age was 32.9 ± 14.3 years, mean donor BMI 25.6 ± 4.3 kg/m(2), and mean donor creatinine 1.13 ± 0.58 mg/dL. Main cause of death was trauma (62.9%). In total, 125 kidney transplantations were performed, with female predominance (53.6%) and mean age 33.8 ± 11.8 years. Of these, 66.4% used basiliximab and 33.6% Thymoglobulin. Thymoglobulin patients were significantly older, with lower weight and BMI, and were on dialysis longer than basiliximab patients. DGF was present in 19.3% of basiliximab patients vs 16.7% in Thymoglobulin patients, acute rejection occurred in 16.9% of basiliximab patients vs 19% Thymoglobulin patients. A total of 33.7% basiliximab patients were hospitalized during the first year vs 47.6% Thymoglobulin-induced patients (P > .05). Mean graft survival was 84.2 ± 5.3 months (73.8-94.7) basiliximab vs 32.4 ± 28.7 months (28.7-36.1) Thymoglobulin, Kaplan-Meier survival did not show statistically significant differences between groups (P = .276; CI 95%).


CONCLUSIONS
Similar transplant outcomes were obtained using basiliximab or Thymoglobulin induction in our population.
Department of Organ Transplantation, Instituto Mexicano del Seguro Social (IMSS), Unidades Medicas de Alta Especialidad (UMAE), Veracruz, Mexico. Electronic address: gmtzmier@gmail.com.
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G
Martinez-Mier
Department of Organ Transplantation, Instituto Mexicano del Seguro Social (IMSS), Unidades Medicas de Alta Especialidad (UMAE), Veracruz, Mexico.
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Soto-Miranda
Department of Nephrology, Hospital de Alta Especialidad de Veracruz, Veracruz, Mexico.
S F
SF
Avila-Pardo
Department of Organ Transplantation, Instituto Mexicano del Seguro Social (IMSS), Unidades Medicas de Alta Especialidad (UMAE), Veracruz, Mexico.
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Budar-Fernandez
Department of Organ Transplantation, Instituto Mexicano del Seguro Social (IMSS), Unidades Medicas de Alta Especialidad (UMAE), Veracruz, Mexico.
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LJ
Mateu-Rivera
Department of Organ Transplantation, Instituto Mexicano del Seguro Social (IMSS), Unidades Medicas de Alta Especialidad (UMAE), Veracruz, Mexico.
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Mendez-Lopez
Department of Research, Instituto Mexicano del Seguro Social (IMSS), Unidades Medicas de Alta Especialidad (UMAE), Veracruz, Mexico.
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Trujillo-Martinez
Department of Research, Instituto Mexicano del Seguro Social (IMSS), Unidades Medicas de Alta Especialidad (UMAE), Veracruz, Mexico.
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A
Uscanga-Montesano
Department of Research, Instituto Mexicano del Seguro Social (IMSS), Unidades Medicas de Alta Especialidad (UMAE), Veracruz, Mexico.
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Avila Y Falfan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D000077552:Basiliximab; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003404:Creatinine; D016572:Cyclosporine / Q000627:therapeutic use; D051799:Delayed Graft Function / Q000401:mortality; D005260:Female; D006084:Graft Rejection / Q000401:mortality; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods / Q000401:mortality; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data; D055815:Young Adult
D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D016572:Cyclosporine; D000077552:Basiliximab; D003404:Creatinine; C512542:thymoglobulin