The impact of different induction immunosuppression protocols on patient survival, graft survival and acute graft rejection after kidney transplantation

Bratislava Medical Journal

article

Matej VNUCAK¹  Karol GRANAK¹  Monika BELIANCINOVA¹  Igor GALA²  Michaela CHRAPEKOVA³  Andrea KOVACOVA³  Luboslav BENA²  Zuzana ZILINSKA³  Ivana DEDINSKA¹ 

[1] Transplantation Center, University Hospital in Martin and Jessenius Medical Faculty of the Comenius University;Transplant Department, L. Pasteur’s University Hospital;Department of Urology with Kidney Transplant Center, University Hospital in Bratislava, Faculty of Medicine, Comenius University in Bratislava;5th Department of Internal Medicine, University Hospital Bratislava, Bratislava, Comenius University Faculty of Medicine

关键词: kidney transplantation;    induction immunosuppression;    graft survival;    patient survival;    acute kidney rejection;   

DOI  :  10.4149/BLL_2022_117

学科分类：医学（综合）

来源: AEPress, s.r.o.

【 摘 要 】

OBJECTIVES: The aim of the study was to stratify the immunological risk based on the presence of risk factors using different induction immunosuppressive protocols.BACKGROUND: The path to successful kidney transplantation reflects the accuracy of immunological risk assessment and choice of correct induction and maintenance of immunosuppression to avoid acute kidney rejection.METHODS: We performed a multicentre prospective analysis consisting of patients after kidney transplantation with a 12-month follow-up. RESULTS: In total, 152 kidney transplant recipients were included, of whom 100 were males (66.4 %). We divided patients according to the induction immunosuppression as follows: no induction (n = 19), induction with basiliximab (n = 60), and induction with ATG at cumulative doses of 3.5 mg/kg (n = 42) and 6 mg/kg (n = 31). In our study, we demonstrated a shorter survival of patients without induction immunosuppression. In the basiliximab group, the duration of dialysis ≥ 3 years (p = 0.0191), cold ischaemia time ≥ 1,020 minutes or expected delayed graft function (p < 0.0001) are independent risk factors for graft loss (p = 0.0097).CONCLUSIONS: Risk of no induction immunosuppression significantly exceeds the risks associated with its administration and is desirable even in patients at low immunological risk. Induction immunosuppression should be tailored individually and thus differ from patient to patient (Tab. 6, Fig. 1, Ref. 15).

【 授权许可】

CC BY