Get access

Multivariate analysis of antibody induction therapy and their associated outcomes in live donor kidney transplantation in the recent era

Authors


  • Conflict of interest: The authors of this manuscript have no conflicts of interest to disclose.

Corresponding author: Dr. Suphamai Bunnapradist, Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, 1033 Gayley Ave. Suite 208, Los Angeles, CA 90095, USA.
Tel.: 310 794 8516; fax: 310 794 8589; e-mail: bunnapradist@mednet.ucla.edu

Abstract

Emami S, Huang E, Kuo H-T, Kamgar M, Bunnapradist S. Multivariate analysis of antibody induction therapy and their associated outcomes in live donor kidney transplantation in the recent era.
Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01517.x.
© 2011 John Wiley & Sons A/S.

Abstract:  The majority of kidney transplant recipients in the United States receive antibody induction, but its impact on outcomes in living donor transplant is not well-described. We used Organ Procurement and Transplant Network/United Network for Organ Sharing (OPTN/UNOS) data as of November 2009 to compare acute rejection (AR) and graft survival among all primary adult living donor kidney recipients of no antibody induction, antithymocyte globulin (ATG) and interleukin-2 receptor antagonists (IL-2RA) in an earlier era (1998–2002; n = 21 919) and a later era (2003–2008, n = 26 837). The incidence of AR in the overall cohort decreased from 18.5% in 1998 to 8% in 2008. From 1998 to 2002, antibody induction was associated with a decreased risk of acute rejection at six months (RR 0.67, 95% CI 0.62–0.72) and one yr (RR 0.71, 0.65–0.76), while in the recent era, induction was not associated with acute rejection at six months (RR 0.97, 0.88–1.07) or one yr (RR 1.01, 0.91–1.10). There was no difference in graft survival over five yr with antibody induction in either era. Although antibody induction was associated with a decreased risk of AR from 1998 to 2002, it was not associated with a decreased risk of acute rejection from 2003 to 2008, nor was it associated with a difference in graft survival in either era.

Get access to the full text of this article

Ancillary