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- Title
Role of Induction in a Haplomatch, Related, Low-Risk, Living-Donor Kidney Transplantation with Triple Drug Immunosuppression: A Single-Center Study.
- Authors
Jha, Pranaw K.; Bansal, Shyam B.; Sharma, Reetesh; Sethi, Sidharth K.; Bansal, Dinesh; Nandwani, Ashish; Kher, Ajay; Yadav, Dinesh K.; Gadde, Ashwini; Mahapatra, Amit K.; Rana, Abhyuday S.; Sodhi, Puneet; Jain, Manish; Kher, Vijay
- Abstract
Background: The role of induction in low-risk, living-donor kidney transplants being treated with tacrolimus, mycophenolate mofetil, and prednisolone is debatable. Materials and Methods: This was a retrospective study that consisted of patients undergoing living kidney transplantation between February 2010 and June 2021 with a related haplomatch donor, with maintenance immunosuppression of tacrolimus, mycophenolate mofetil, and prednisolone. High-risk transplants, such as second or more transplants, immunologically incompatible transplants, and steroid-free transplants, were excluded. Patients were divided into three groups: no induction, basiliximab induction, and thymoglobulin induction, and the outcomes of all three were compared. Results: A total of 350 transplants were performed. There was a significant difference in the recipient sex distribution (P = 0.0373) and the number of preemptive transplants (P = 0.0272) between the groups. Other parameters were comparable. Biopsy-proven acute rejection (BPAR) was significantly less frequent in the thymoglobulin group than in the no-induction (5.3% vs. 17.5%; P = 0.0051) or basiliximab (5.3% vs. 18.8%; P = 0.0054) group. This persisted even after we performed multivariate regression analysis (thymoglobulin vs. no-induction group, P = 0.0146; thymoglobulin vs. basiliximab group, P = 0.0237). There was no difference in BPAR between the basiliximab and no-induction groups. There were no differences in other outcomes between the groups. Conclusion: In a low-risk haplomatch, related, living-donor kidney transplant on tacrolimus, mycophenolate mofetil, and prednisolone, BPAR was significantly lower with thymoglobulin as opposed to no induction or basiliximab induction with a similar short-term patient and death-censored graft survival and infection rates. Basiliximab did not provide any benefit over no induction.
- Subjects
KIDNEY transplantation; ORGAN donors; HEMATOPOIETIC stem cell transplantation; RISK assessment; PATIENTS; TRANSPLANTATION of organs, tissues, etc.; T-test (Statistics); RESEARCH funding; MYCOPHENOLIC acid; MULTIPLE regression analysis; FISHER exact test; RETROSPECTIVE studies; DESCRIPTIVE statistics; PREDNISOLONE; MANN Whitney U Test; KAPLAN-Meier estimator; LOG-rank test; MEDICAL records; ACQUISITION of data; TACROLIMUS; ANALYSIS of variance; COMPARATIVE studies; DATA analysis software; IMMUNOSUPPRESSION; THERAPEUTICS
- Publication
Indian Journal of Nephrology, 2024, Vol 34, Issue 3, p246
- ISSN
0971-4065
- Publication type
Article
- DOI
10.4103/ijn.ijn_84_23