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Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients

The choice between Basiliximab (BSX) or Anti-Thymocyte Globulin (ATG) as induction therapy in non-immunized kidney transplant recipients remains uncertain. Whilst ATG may allow steroid withdrawal and a decrease in tacrolimus, it also increases infectious complications. We investigated outcomes in no...

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Autores principales: Masset, Christophe, Kerleau, Clarisse, Blancho, Gilles, Hourmant, Maryvonne, Walencik, Alexandre, Ville, Simon, Kervella, Delphine, Cantarovich, Diego, Houzet, Aurélie, Giral, Magali, Garandeau, Claire, Dantal, Jacques
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935561/
https://www.ncbi.nlm.nih.gov/pubmed/36819125
http://dx.doi.org/10.3389/ti.2023.10816
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author Masset, Christophe
Kerleau, Clarisse
Blancho, Gilles
Hourmant, Maryvonne
Walencik, Alexandre
Ville, Simon
Kervella, Delphine
Cantarovich, Diego
Houzet, Aurélie
Giral, Magali
Garandeau, Claire
Dantal, Jacques
author_facet Masset, Christophe
Kerleau, Clarisse
Blancho, Gilles
Hourmant, Maryvonne
Walencik, Alexandre
Ville, Simon
Kervella, Delphine
Cantarovich, Diego
Houzet, Aurélie
Giral, Magali
Garandeau, Claire
Dantal, Jacques
author_sort Masset, Christophe
collection PubMed
description The choice between Basiliximab (BSX) or Anti-Thymocyte Globulin (ATG) as induction therapy in non-immunized kidney transplant recipients remains uncertain. Whilst ATG may allow steroid withdrawal and a decrease in tacrolimus, it also increases infectious complications. We investigated outcomes in non-immunized patients receiving a very low dosage of ATG versus BSX as induction. Study outcomes were patient/graft survival, cumulative probabilities of biopsy proven acute rejection (BPAR), infectious episode including CMV and post-transplant diabetes (PTD). Cox, logistic or linear statistical models were used depending on the studied outcome and models were weighted on propensity scores. 100 patients received ATG (mean total dose of 2.0 mg/kg) and 83 received BSX. Maintenance therapy was comparable. Patient and graft survival did not differ between groups, nor did infectious complications. There was a trend for a higher occurrence of a first BPAR in the BSX group (HR at 1.92; 95%CI: [0.77; 4.78]; p = 0.15) with a significantly higher BPAR episodes (17% vs 7.3%, p = 0.01). PTD occurrence was significantly higher in the BSX group (HR at 2.44; 95%CI: [1.09; 5.46]; p = 0.03). Induction with a very low dose of ATG in non-immunized recipients was safe and associated with a lower rate of BPAR and PTD without increasing infectious complications.
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spelling pubmed-99355612023-02-18 Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients Masset, Christophe Kerleau, Clarisse Blancho, Gilles Hourmant, Maryvonne Walencik, Alexandre Ville, Simon Kervella, Delphine Cantarovich, Diego Houzet, Aurélie Giral, Magali Garandeau, Claire Dantal, Jacques Transpl Int Health Archive The choice between Basiliximab (BSX) or Anti-Thymocyte Globulin (ATG) as induction therapy in non-immunized kidney transplant recipients remains uncertain. Whilst ATG may allow steroid withdrawal and a decrease in tacrolimus, it also increases infectious complications. We investigated outcomes in non-immunized patients receiving a very low dosage of ATG versus BSX as induction. Study outcomes were patient/graft survival, cumulative probabilities of biopsy proven acute rejection (BPAR), infectious episode including CMV and post-transplant diabetes (PTD). Cox, logistic or linear statistical models were used depending on the studied outcome and models were weighted on propensity scores. 100 patients received ATG (mean total dose of 2.0 mg/kg) and 83 received BSX. Maintenance therapy was comparable. Patient and graft survival did not differ between groups, nor did infectious complications. There was a trend for a higher occurrence of a first BPAR in the BSX group (HR at 1.92; 95%CI: [0.77; 4.78]; p = 0.15) with a significantly higher BPAR episodes (17% vs 7.3%, p = 0.01). PTD occurrence was significantly higher in the BSX group (HR at 2.44; 95%CI: [1.09; 5.46]; p = 0.03). Induction with a very low dose of ATG in non-immunized recipients was safe and associated with a lower rate of BPAR and PTD without increasing infectious complications. Frontiers Media S.A. 2023-02-03 /pmc/articles/PMC9935561/ /pubmed/36819125 http://dx.doi.org/10.3389/ti.2023.10816 Text en Copyright © 2023 Masset, Kerleau, Blancho, Hourmant, Walencik, Ville, Kervella, Cantarovich, Houzet, Giral, Garandeau, Dantal and the Nantes DIVAT Consortium. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Masset, Christophe
Kerleau, Clarisse
Blancho, Gilles
Hourmant, Maryvonne
Walencik, Alexandre
Ville, Simon
Kervella, Delphine
Cantarovich, Diego
Houzet, Aurélie
Giral, Magali
Garandeau, Claire
Dantal, Jacques
Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients
title Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients
title_full Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients
title_fullStr Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients
title_full_unstemmed Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients
title_short Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients
title_sort very low dose anti-thymocyte globulins versus basiliximab in non-immunized kidney transplant recipients
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935561/
https://www.ncbi.nlm.nih.gov/pubmed/36819125
http://dx.doi.org/10.3389/ti.2023.10816
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