Efficacy and Safety of Induction Therapy in Kidney Transplant Recipients: A Propensity Score Matching Analysis in a Multicenter Retrospective Observational Study

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-04-30 DOI:10.1016/j.transproceed.2025.04.003

Vural Taner Yılmaz , Erol Demir , Hüseyin Koçak , Ayşe Sinangil , Rahmi Yılmaz , Şebnem Karakan , Rezzan Eren Sadioğlu , Berna Yelken , Ebru Ok , Murathan Uyar , Arzu Velioğlu , Ergün Parmaksız , Elif Arı Bakır , Ülkem Çakır , Nurhan Seyahi , Hamad Dheir , Aydın Türkmen

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引用次数: 0

Abstract

Bacground

This study aimed to compare the efficacy and safety of induction treatments in kidney transplant recipients.

Methods

A total of 2564 kidney transplant recipients from 15 transplant centers were included in the study and were categorized into 3 groups for comparison. Group 1: No induction (n = 222, 8.7%), Group 2: Anti-T lymphocyte globulin (ATLG, n = 1794, 70%) and Group 3: Basiliximab (n = 548, 21.4%). The results were compared across 3 post-transplant periods: the first month, the 1st to 6th month, and the 6th to 12th month.

Results

Prior to propensity score matching (PSM), there were no significant differences in graft/patient survival, BKV (polyomavirus) incidence, or rejection rates during the first month among the groups. However, the Anti-T lymphocyte globulin (ATLG) group exhibited higher rates of developing donor-specific antibodies (DSA), cytomegalovirus (CMV) infection, general infections, and delayed graft function (DGF), along with higher rejection rates at 1 month post-transplant. After the PSM analysis, rejection rates (which were higher in the ATLG group compared to the Basiliximab group only in the first month), graft/patient loss, and BKV rates were comparable. Infection, CMV, and DSA rates remained elevated in the ATLG group. Clinical results of groups 1 and 3 were similar.

Conclusions

This study shown that ATLG provides positive clinical results despite increased infection and DSA formation in patients with high immunological risk, whereas the efficacy and necessity of induction in patients with low-moderate immunological risk is debatable.

查看原文本刊更多论文

肾移植受者诱导治疗的有效性和安全性：多中心回顾性观察性研究的倾向评分匹配分析。

背景：本研究旨在比较肾移植受者诱导治疗的疗效和安全性。方法：将来自15家肾移植中心的2564例肾移植受者分为3组进行比较。第1组：无诱导（n = 222, 8.7%），第2组：抗t淋巴细胞球蛋白（n = 1794, 70%），第3组：Basiliximab （n = 548, 21.4%）。结果在移植后的3个时期进行比较：第一个月，第1至6个月，第6至12个月。结果：在倾向评分匹配（PSM）之前，两组在移植/患者存活率、BKV（多瘤病毒）发病率或第一个月的排异率方面没有显著差异。然而，抗t淋巴细胞球蛋白（ATLG）组表现出更高的供体特异性抗体（DSA）、巨细胞病毒（CMV）感染、一般感染和移植物功能延迟（DGF）发生率，以及移植后1个月更高的排异率。PSM分析后，排异率（ATLG组仅在第一个月高于Basiliximab组）、移植物/患者损失和BKV率具有可比性。ATLG组的感染、CMV和DSA率仍然升高。1、3组临床结果相似。结论：本研究表明，尽管ATLG在高免疫风险患者中增加了感染和DSA的形成，但其临床效果是积极的，而在中低免疫风险患者中诱导的疗效和必要性是有争议的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.