PDF(Pubmed)
Abstract：
The aim of this study is to assess the outcomes of different induction therapies among mild to moderate immunological risk kidney transplants in the era tacrolimus and mycophenolate-derivate based maintenance.
This was a retrospective cohort study using data from the United States Organ Procurement and Transplantation Network among mild to moderate immunological risk living-donor KTRs, defined as having first transplant and panel reactive antibodies less than 20% but with two HLA-DR mismatches. KTRs were divided into two groups based on induction therapy with either thymoglobulin or basiliximab. Instrumental variable regression models were used to assess the effect of induction therapy on acute rejection episodes, serum creatinine levels and graft survival.
Of the entire cohort, 788 patients received basiliximab while 1727 patients received thymoglobulin induction. There were no significant differences between basiliximab versus thymoglobulin induction in acute rejection episodes at one-year post-transplant (coefficient= -0.229, p value = .106), serum creatinine levels at one-year post-transplant (coefficient= -0.024, p value = .128) or death-censored graft survival (coefficient: - <0.001, p value = .201).
This study showed no significant difference in acute rejection episodes or graft survival when using thymoglobulin or basiliximab in mild to moderate immunological risk living donor KTRs, maintained on tacrolimus and mycophenolate-based immunosuppressive regimen.
This was a retrospective cohort study using data from the United States Organ Procurement and Transplantation Network among mild to moderate immunological risk living-donor KTRs, defined as having first transplant and panel reactive antibodies less than 20% but with two HLA-DR mismatches. KTRs were divided into two groups based on induction therapy with either thymoglobulin or basiliximab. Instrumental variable regression models were used to assess the effect of induction therapy on acute rejection episodes, serum creatinine levels and graft survival.
Of the entire cohort, 788 patients received basiliximab while 1727 patients received thymoglobulin induction. There were no significant differences between basiliximab versus thymoglobulin induction in acute rejection episodes at one-year post-transplant (coefficient= -0.229, p value = .106), serum creatinine levels at one-year post-transplant (coefficient= -0.024, p value = .128) or death-censored graft survival (coefficient: - <0.001, p value = .201).
This study showed no significant difference in acute rejection episodes or graft survival when using thymoglobulin or basiliximab in mild to moderate immunological risk living donor KTRs, maintained on tacrolimus and mycophenolate-based immunosuppressive regimen.
摘要：
■这项研究的目的是评估在他克莫司和基于霉酚酸酯衍生物的维持治疗时代，轻度至中度免疫风险肾脏移植中不同诱导疗法的结果。
■这是一项回顾性队列研究，使用来自美国器官采购和移植网络的数据，在轻度至中度免疫风险的活体供者中，定义为首次移植和小组反应性抗体低于20％，但具有两个HLA-DR错配。根据胸腺球蛋白或巴利昔单抗的诱导治疗，将KTRs分为两组。仪器变量回归模型用于评估诱导治疗对急性排斥反应的影响。血清肌酐水平和移植物存活。
■在整个队列中，788例患者接受了巴利昔单抗，而1727例患者接受了胸腺球蛋白诱导。在移植后一年的急性排斥反应中，巴利昔单抗与胸腺球蛋白诱导之间没有显着差异（系数=-0.229，p值=0.106），移植后一年的血清肌酐水平（系数=-0.024，p值=.128）或死亡审查的移植物存活率（系数：-<0.001，p值=.201）。
■这项研究表明，在轻度至中度免疫风险活体供者KTRs中使用胸腺球蛋白或巴利昔单抗时，急性排斥反应发作或移植物存活没有显着差异，维持他克莫司和霉酚酸酯为基础的免疫抑制方案。
■这是一项回顾性队列研究，使用来自美国器官采购和移植网络的数据，在轻度至中度免疫风险的活体供者中，定义为首次移植和小组反应性抗体低于20％，但具有两个HLA-DR错配。根据胸腺球蛋白或巴利昔单抗的诱导治疗，将KTRs分为两组。仪器变量回归模型用于评估诱导治疗对急性排斥反应的影响。血清肌酐水平和移植物存活。
■在整个队列中，788例患者接受了巴利昔单抗，而1727例患者接受了胸腺球蛋白诱导。在移植后一年的急性排斥反应中，巴利昔单抗与胸腺球蛋白诱导之间没有显着差异（系数=-0.229，p值=0.106），移植后一年的血清肌酐水平（系数=-0.024，p值=.128）或死亡审查的移植物存活率（系数：-<0.001，p值=.201）。
■这项研究表明，在轻度至中度免疫风险活体供者KTRs中使用胸腺球蛋白或巴利昔单抗时，急性排斥反应发作或移植物存活没有显着差异，维持他克莫司和霉酚酸酯为基础的免疫抑制方案。
