PMID- 35836670
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2373-8731 (Print)
IS  - 2373-8731 (Electronic)
IS  - 2373-8731 (Linking)
VI  - 7
IP  - 8
DP  - 2021 Aug
TI  - Clinical Correlates and Outcomes of Dual Basiliximab and Antithymocyte Globulin 
      Induction in Kidney Transplant Recipients: A National Study.
PG  - e736
LID - 10.1097/TXD.0000000000001190 [doi]
LID - e736
AB  - The unplanned use of dual induction therapy with interleukin-2 receptor-blocking 
      antibodies (IL2rAb) and antithymocyte globulin (ATG) may portend adverse 
      outcomes. METHODS: We used national transplant registry data to study clinical 
      correlates and outcomes of single versus dual induction therapy in adult 
      kidney-only transplant recipients in the United States (2005-2018). The risk of 
      death and graft loss at 1 and 5 y, according to induction therapy type, was 
      assessed using multivariate Cox regression analysis (adjusted hazard ratio with 
      95% upper and lower confidence limits [(LCL)aHR(UCL)]). RESULTS: Of the 157 351 
      recipients included in the study, 67% were treated with ATG alone, 29% were 
      treated with IL2rAb alone, and 5% were treated with both. Compared with IL2rAb 
      alone, the strongest correlates of dual induction included Black race, calculated 
      panel reactive antibody >/=80%, prednisone-sparing maintenance immunosuppression, 
      more recent transplant eras, longer cold ischemia time, and delayed graft 
      function. Compared with ATG alone, dual induction was associated with an 
      increased 5-y risk of death (aHR (1.07)1.15(1.23); P < 0.0001), death-censored 
      graft failure (aHR (1.05)1.13(1.22); P < 0.05), and all-cause graft failure (aHR 
      (1.06)1.12(1.18); P < 0.0001). CONCLUSIONS: Further research is needed to develop 
      risk-prediction tools to further inform optimal, individualized induction 
      protocols for kidney transplant recipients.
CI  - Copyright (c) 2021 The Author(s). Transplantation Direct. Published by Wolters 
      Kluwer Health, Inc.
FAU - Lam, Ngan N
AU  - Lam NN
AD  - Division of Nephrology, University of Calgary, Calgary, AB, Canada.
FAU - Jeong, Rachel
AU  - Jeong R
AD  - Division of Nephrology, University of Calgary, Calgary, AB, Canada.
FAU - Quinn, Robert R
AU  - Quinn RR
AD  - Division of Nephrology, University of Calgary, Calgary, AB, Canada.
FAU - Ravani, Pietro
AU  - Ravani P
AD  - Division of Nephrology, University of Calgary, Calgary, AB, Canada.
FAU - Xiao, Huiling
AU  - Xiao H
AD  - Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO.
FAU - McAdams-DeMarco, Mara
AU  - McAdams-DeMarco M
AD  - Johns Hopkins University, Baltimore, MD.
FAU - Axelrod, David A
AU  - Axelrod DA
AD  - University of Iowa, Iowa City, IA.
FAU - Schnitzler, Mark A
AU  - Schnitzler MA
AD  - Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO.
FAU - Snyder, Jon J
AU  - Snyder JJ
AD  - Hennepin Healthcare Research Institute, Minneapolis, MN.
FAU - Lentine, Krista L
AU  - Lentine KL
AD  - Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO.
LA  - eng
PT  - Journal Article
DEP - 20210723
PL  - United States
TA  - Transplant Direct
JT  - Transplantation direct
JID - 101651609
PMC - PMC9276156
COIS- K.L.L. serves on the Sanofi-Genzyme speakers bureau. D.A.A. is a consultant to 
      Sanofi-Genzyme. The other authors declare no conflicts of interest.
EDAT- 2022/07/16 06:00
MHDA- 2022/07/16 06:01
PMCR- 2021/07/23
CRDT- 2022/07/15 02:28
PHST- 2021/04/27 00:00 [received]
PHST- 2021/05/19 00:00 [accepted]
PHST- 2022/07/15 02:28 [entrez]
PHST- 2022/07/16 06:00 [pubmed]
PHST- 2022/07/16 06:01 [medline]
PHST- 2021/07/23 00:00 [pmc-release]
AID - 10.1097/TXD.0000000000001190 [doi]
PST - epublish
SO  - Transplant Direct. 2021 Jul 23;7(8):e736. doi: 10.1097/TXD.0000000000001190. 
      eCollection 2021 Aug.