PMID- 22306574
OWN - NLM
STAT- MEDLINE
DCOM- 20120416
LR  - 20171116
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 93
IP  - 5
DP  - 2012 Mar 15
TI  - Effects of antibody induction on transplant outcomes in human leukocyte antigen 
      zero-mismatch deceased donor kidney recipients.
PG  - 493-502
LID - 10.1097/TP.0b013e3182427fc3 [doi]
AB  - BACKGROUND: We aimed to investigate the impact of antibody induction on outcomes 
      in human leukocyte antigen (HLA) 0-mismatched deceased donor kidney recipients. 
      METHODS: Using the Organ Procurement and Transplant Network/United Network of 
      Organ Sharing database as of November 2009, we identified 44,008 adult deceased 
      donor kidney recipients who received primary kidney transplants alone between 
      2003 and 2008 (HLA 0 mismatch, n = 6274; >/= 1 mismatch, n=37,734; median 
      follow-up: 834 days). The impact of induction (thymoglobulin, interleukin-2 
      receptor antagonists [IL-2RA], or alemtuzumab; vs. no induction) on rejection 
      (initial hospitalization, 6 months, first year), death-censored graft failure, 
      and mortality were analyzed using multivariate logistic and Cox regression in the 
      two groups. The impact of individual agents on outcomes was further analyzed in 
      0-mismatch recipients. RESULTS: There was a decreased risk of rejection over the 
      first 6 months for HLA 0-mismatch recipients of antibody induction (adjusted odds 
      ratio=0.71, P=0.003), but this effect was not observed at 1 year; in comparison, 
      induction was associated with a reduced risk of rejection over the first year for 
      HLA-mismatched recipients (0.87, P<0.001). The use of thymoglobulin (0.72, 
      P=0.02) and IL-2RA (0.67, P=0.004) was associated with a decreased risk of 
      rejection compared with no-induction at 6 months but was not different at 1 year 
      (thymoglobulin: 0.77, P=0.05; IL-2RA:0.81, P=0.11) in HLA 0-mismatched 
      recipients. Induction was not associated with improved graft or patient survival 
      in HLA 0-mismatch recipients. CONCLUSION: In HLA 0-mismatch deceased donor 
      recipients, antibody induction was associated with a decreased risk of rejection 
      at 6 months posttransplant. Its use did not improve graft and patient survival 
      over the follow-up period.
FAU - Kuo, Hung-Tien
AU  - Kuo HT
AD  - Division of Nephrology, Department of Medicine, David Geffen School of Medicine 
      at UCLA, Los Angeles, CA, USA.
FAU - Huang, Edmund
AU  - Huang E
FAU - Emami, Sina
AU  - Emami S
FAU - Pham, Phuong-Thu
AU  - Pham PT
FAU - Wilkinson, Alan H
AU  - Wilkinson AH
FAU - Danovitch, Gabriel M
AU  - Danovitch GM
FAU - Bunnapradist, Suphamai
AU  - Bunnapradist S
LA  - eng
GR  - 231-00-0115/PHS HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Receptors, Interleukin-2)
RN  - 3A189DH42V (Alemtuzumab)
RN  - D7RD81HE4W (thymoglobulin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Alemtuzumab
MH  - Antibodies, Monoclonal, Humanized/*therapeutic use
MH  - Antilymphocyte Serum/*therapeutic use
MH  - Female
MH  - Graft Rejection/immunology/mortality/*prevention & control
MH  - Graft Survival/*drug effects
MH  - HLA Antigens/*immunology
MH  - *Histocompatibility
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kaplan-Meier Estimate
MH  - Kidney Transplantation/*immunology/mortality
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Proportional Hazards Models
MH  - Receptors, Interleukin-2/immunology
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Tissue and Organ Procurement
MH  - Treatment Outcome
MH  - United States
MH  - Young Adult
EDAT- 2012/02/07 06:00
MHDA- 2012/04/17 06:00
CRDT- 2012/02/07 06:00
PHST- 2012/02/07 06:00 [entrez]
PHST- 2012/02/07 06:00 [pubmed]
PHST- 2012/04/17 06:00 [medline]
AID - 10.1097/TP.0b013e3182427fc3 [doi]
PST - ppublish
SO  - Transplantation. 2012 Mar 15;93(5):493-502. doi: 10.1097/TP.0b013e3182427fc3.