Basiliximab is associated with a lower incidence of De novo donor-specific HLA antibodies in kidney transplant recipients: A single-center experience |
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| Institution: | 1. Department of Transplantation, Mayo Clinic, Jacksonville, FL, United States of America;2. Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, United States of America;3. Health Sciences Research, Mayo Clinic, Jacksonville, FL, United States of America;1. Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan;2. Department of Diagnostic Pathology, Graduate School of Medicine, Osaka City University, Osaka, Japan;3. Department of Gastroenterology, Graduate School of Medicine, Osaka City University, Osaka, Japan;1. Department of General, Visceral, and Transplant Surgery, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Marchioninistraße 15, 81377 Munich, Germany;2. Walter-Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität Munich, Marchioninistraße 15, 81377 Munich, Germany;3. Institute of Laboratory Medicine, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Marchioninistraße 15, 81377 Munich, Germany;1. Hospital of LMU Munich, Division of General, Visceral, Vascular and Transplant Surgery, Munich, Bavaria, Germany;2. Hospital of LMU Munich, Division of Nephrology, Department of Medicine IV, Munich, Bavaria, Germany;3. University Hospital Cologne, Department for General, Visceral, Cancer and Transplant Surgery, Cologne, North Rhine-Westphalia, Germany;1. Department of Neurology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai City, Shandong Province, China;2. Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai City, Shandong Province, China;1. Department of Respiratory Medicine, Tokyo Women''s Medical University, Tokyo, Japan;2. Department of Infectious Diseases, Tokyo Women''s Medical University, Tokyo, Japan;3. Department of Infection Prevention and Control, Tokyo Women''s Medical University, Tokyo, Japan;4. Department of Pharmacy, Tokyo Women''s Medical University, Tokyo, Japan;5. Department of Urology, Tokyo Women''s Medical University, Tokyo, Japan;6. Department of General Medicine, Tokyo Women''s Medical University, Tokyo, Japan;7. Department of Surgery, Institute of Gastroenterology, Tokyo Women''s Medical University, Tokyo, Japan;8. Department of Hematology, Tokyo Women''s Medical University, Tokyo, Japan |
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| Abstract: | PurposeInduction immunosuppression has improved the long-term outcomes after kidney transplant. This study explores the association of different induction immunosuppression medications (Basiliximab vs. Alemtuzumab vs. rabbit Antithymocyte Globulin) used at the time of kidney transplant with the development of de novo donor-specific HLA antibodies (DSA) in the first 12 months post-transplant period.MethodsA total of 390 consecutive kidney transplant recipients (KTR), between 2016 and 2018, were included in the analysis. A 104 (26.6%) received Basiliximab, 186 (47.6%) received Alemtuzumab, and 100 (25.6%) received rabbit Antithymocyte Globulin (rATG) for induction. All recipients had a negative flow cytometry crossmatch before transplant. Serum samples at 4- and 12-months post-transplant were assessed for the presence of de novo HLA DSA. kidney allograft function was compared among the three groups with calculated Creatinine Clearance on 24 h urine collection.ResultsDe novo HLA DSA were detected in total of 81 (20.8%) patients within 12 months post-transplant. De novo HLA DSA were detected in 12/104 (11.5%), 43/186 (23.11%), and 26/100 (26%) KTR that received Basiliximab, Alemtuzumab, and rATG respectively (p = 0.006). KTR that received Basiliximab were significantly older, and the last follow-up creatinine clearance was significantly lower at 42 ml/min compared to KTR that received Alemtuzumab or rATG (p = 0.006).ConclusionInduction immunosuppression utilizing Basiliximab is associated with significant reduction in development of de novo DSA within the first 12-months post kidney transplant but had lower creatinine clearance with long-term follow up. |
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