Comparative study of induction therapy during kidney transplantation

Objective To explore the efficacy and safety of two antibody induction therapies during donor after cardiac death (DCD) kidney transplantation. Methods Retrospective analysis was performed for the clinical data of DCD kidney patients in 2016. Patients using basiliximab monoclonal or thymoglobulin (ATG) polyclonal antibody were divided into two groups. Early postoperative biopsy proven, acute rejection rate, creatinine level and patient/graft survival rate were compared between two groups at 1, 3 or 6 month post-operation. Results Basiliximab (n=44) and ATG (n=60) was used as induction. No significant inter-group difference existed in donor age, primary disease, creatinine pre-donation, recipient age or cause of renal failure. And recipient male ratio and body weight were greater in ATG group than those in basiliximab group [87% vs. 55%; (70±13) vs. (64±12) kg]. Outcomes of basiliximab group showed acute rejection rate was 9%, average creatinine 112.4 at 1 month, 127.0 at 3 months and 107.8 at 6 months and total infection rate 16%. Graft/patient 6-month survival rates were 95%(42/44)and 98%(43/44). Outcomes of ATG group showed that acute rejection rate was 3%, average creatinine 135.6 at 1 month, 119.0 at 3 months and 118.0 at 6 months and total infection rate 22%. Graft/patient 6-month survival rates were both 100% (60/60). Conclusions During DCD kidney transplantation, both induction therapies may prevent acute rejection immediately post-operation. No difference exists in acute rejection rate, infection rate, graft/recipient 6-month survival rate or graft function. These two inductions have an excellent early prognosis. Key words: Kidney transplantation; Monoclonal antibody; Acute rejection