A retrospective analysis was conducted on 110 consecutive A2-to-B kidney transplant recipients between January 2015 and December 2022. Of these, 46 (41.8%) received Basiliximab, while 64 (58.2%) received Alemtuzumab as induction therapy. Demographics and comorbidities data were collected and compared between the two groups. Serum samples collected at 4- and 12-month intervals post-transplant were used to assess the presence of de novo DSA. Kidney allograft function was evaluated by monitoring serum creatinine levels and assessing Creatinine Clearance based on 24-h urine collection at various time points.
During the follow-up period, 20.00% of patients who received Alemtuzumab developed de novo DSA, whereas none of the patients induced with Basiliximab developed de novo DSA (p = 0.038). Recipients who received Basiliximab were older (mean age = 72.00) and received higher Kidney Donor Profile Index (KDPI) kidneys (mean = 75) compared to those induced with Alemtuzumab (mean age = 58.00, mean KDPI = 49) (p < 0.001), with no significant difference observed in the last follow-up creatinine clearance or creatinine levels between the two groups (p = 0.28).
The use of Basiliximab as induction immunosuppression in A2-to-B kidney transplant recipients is associated with a lower incidence of de novo HLA DSA formation without significant differences in overall renal function compared to Alemtuzumab.
方法:对2015年1月至2022年12月期间110例连续的A2-B肾移植受者进行了回顾性分析。其中,46例(41.8%)接受了巴利昔单抗,64例(58.2%)接受了Alemtuzumab作为诱导治疗。收集并比较两组人口统计学和合并症数据。移植后以4个月和12个月的间隔收集的血清样品用于评估从头DSA的存在。通过监测血清肌酐水平并根据不同时间点的24小时尿液收集评估肌酐清除率来评估肾脏同种异体移植功能。
结果:在随访期间,接受Alemtuzumab的患者中有20.00%的患者从头DSA,而巴利昔单抗诱导的患者均未出现从头DSA(p=0.038)。接受巴利昔单抗治疗的患者年龄较大(平均年龄=72.00),接受肾脏供者资料指数(KDPI)(平均=75),与使用阿仑珠单抗治疗的患者相比(平均年龄=58.00,平均KDPI=49)(p<0.001),两组末次随访肌酐清除率或肌酐水平无显著差异(p=0.28).
结论:与Alemtuzumab相比,在A2-to-B肾移植受者中使用巴利昔单抗作为诱导免疫抑制与从头HLADSA形成的发生率较低相关,而总体肾功能无显著差异。