Effect of different induction therapies on the clinical outcomes of ABO-incompatible living donor kidney transplantation recipients

W. Lei, Shuaihui Liu, Jing-yi Zhou, Jia Shen, W. Xie, X. Yao, Menger Cen, Jianghua Chen
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Abstract

Objective To compare the clinical outcomes of low-dose rabbit antithymocyte globulin (rATG) vs basiliximab as induction therapy in recipients of ABO-incompatible kidney transplantation (ABOi-KT). Methods Retrospective analysis was conducted for e the clinical data of 40 ABOi-KT recipients between March 2017 and March 2019. 17 recipients of them received induction therapy with basiliximab (basiliximab group) while another 23 recipients received low-dose rATG (rATG group, rATG 25 mg/d×3 d). During a median follow-up period of 282 days, the data of serum creatinine and eGFR at 1 week and 1 month, graft survival rate and complication rate of two groups were compared. Results No significant difference existed in age, gender, dialytic modality/duration, blood groups of recipients, HLA mis-match, blood group antibody titers, dose of rituximab, blood groups of donors or donor age (P>0.05). The times of double filtration plasmapheresis in Basiliximab group were more (P 0.05). No significant difference existed in graft survival rate. No significant difference existed in rate of acute rejection, parvovirus B19 infection, urinary tract infection or hematoma. Conclusions Low-dose of rATG is as effective as basiliximab for ABOi-KT recipients. And rATG does not increase the rate of infection. Key words: Kidney transplantation; ABO blood group; Incompatible; Living donor; Rabbit antithymocyte globulin; Basiliximab
不同诱导疗法对abo血型不相容活体肾移植受者临床结局的影响
目的比较低剂量兔抗胸腺细胞球蛋白(rATG)与巴厘昔单抗诱导治疗abo血型不相容肾移植(ABOi-KT)的临床疗效。方法回顾性分析2017年3月至2019年3月40例ABOi-KT患者的临床资料。其中17例患者接受basiliximab诱导治疗(basiliximab组),23例患者接受低剂量的rATG治疗(rATG组,rATG 25 mg/d×3 d),中位随访282天,比较两组患者1周和1个月的血清肌酐和eGFR、移植物存活率和并发症发生率。结果年龄、性别、透析方式/持续时间、受体血型、HLA错配、血型抗体滴度、利妥昔单抗剂量、献血者血型、献血者年龄差异无统计学意义(P < 0.05)。巴昔昔单抗组双滤过血浆置换次数较多(p0.05)。移植物存活率无显著差异。急性排斥反应、细小病毒B19感染、尿路感染和血肿发生率差异无统计学意义。结论对于ABOi-KT患者,低剂量大鼠肝素治疗与巴昔昔单抗治疗效果相当。而且rATG并不会增加感染率。关键词:肾移植;ABO血型;不相容的;活体供;兔抗胸腺细胞球蛋白;Basiliximab
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