학술논문
Induction therapy in simultaneous pancreas-kidney transplantation: thymoglobulin versus basiliximab.
Document Type
Academic Journal
Author
Fernández-Burgos I; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain. Electronic address: isabel.fernandez.burgos@gmail.com.; Montiel Casado MC; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.; Pérez-Daga JA; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.; Aranda-Narváez JM; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.; Sánchez-Pérez B; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.; León-Díaz FJ; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.; Cabello-Díaz M; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.; Rodríguez-Burgos D; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.; Hernández-Marrero D; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.; Santoyo-Santoyo J; Department of Digestive Surgery and Transplantation, Hospital Regional Universitario de Málaga, Málaga, Spain.
Source
Publisher: Elsevier Science Inc Country of Publication: United States NLM ID: 0243532 Publication Model: Print Cited Medium: Internet ISSN: 1873-2623 (Electronic) Linking ISSN: 00411345 NLM ISO Abbreviation: Transplant Proc Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Induction therapy for simultaneous pancreas-kidney (SPK) transplantation. Both thymoglobulin (ATG) and basiliximab are the most-used types of induction antibodies therapies in clinical practice. The aim of our report was to analyze our experience comparing 2 induction therapies, for SPK transplantation in terms of pancreas and patient survival, as well as rejection rate.
Methods: We reviewed retrospectively a total of 97 SPK transplantations in our institution. The cases were divided according to induction therapy in 2 groups, basiliximab (n = 38) and ATG (n = 59). Rejection, patient and graft survival, and postoperative complications were analyzed.
Results: Survival in the ATG group was better without statistical difference at 1-, 3-, and 5-year follow-up (97%, 95%, and 95% versus 92%, 90%, and 87%, respectively). No difference was detected in pancreas graft survival after 1-, 3-, and 5-year follow-up (basiliximab 85%, 80%, and 77% versus ATG 84%, 84%, and 81%, respectively; log-rank, 0.847). Overall cellular rejection and early rejection were more common in the basiliximab group (30 versus 14%, and 21% versus 6%). In the multivariate analysis considering human leukocyte antigen (HLA) mismatches, the ATG group was a protective factor for cellular rejection. Major complications (Grade III-IV) and median length of the hospital stay were higher in the basiliximab group (55% versus 34%, P = .057, and 21 versus 16 days, P = .056).
Conclusions: The pancreas graft survival was not affected by induction therapy. ATG induction therapy compared with basiliximab is associated with lower overall and early rejection rate. Over time this difference disappears.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Methods: We reviewed retrospectively a total of 97 SPK transplantations in our institution. The cases were divided according to induction therapy in 2 groups, basiliximab (n = 38) and ATG (n = 59). Rejection, patient and graft survival, and postoperative complications were analyzed.
Results: Survival in the ATG group was better without statistical difference at 1-, 3-, and 5-year follow-up (97%, 95%, and 95% versus 92%, 90%, and 87%, respectively). No difference was detected in pancreas graft survival after 1-, 3-, and 5-year follow-up (basiliximab 85%, 80%, and 77% versus ATG 84%, 84%, and 81%, respectively; log-rank, 0.847). Overall cellular rejection and early rejection were more common in the basiliximab group (30 versus 14%, and 21% versus 6%). In the multivariate analysis considering human leukocyte antigen (HLA) mismatches, the ATG group was a protective factor for cellular rejection. Major complications (Grade III-IV) and median length of the hospital stay were higher in the basiliximab group (55% versus 34%, P = .057, and 21 versus 16 days, P = .056).
Conclusions: The pancreas graft survival was not affected by induction therapy. ATG induction therapy compared with basiliximab is associated with lower overall and early rejection rate. Over time this difference disappears.
(Copyright © 2015 Elsevier Inc. All rights reserved.)