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Original Article

Korean J Transplant 2019; 33(4): 118-127

Published online December 31, 2019

https://doi.org/10.4285/jkstn.2019.33.4.118

© The Korean Society for Transplantation

Comparison of clinical outcomes of deceased donor kidney transplantations, with a focus on three induction therapies

Eun Sung Jeong1, Kyo Won Lee1, Sang Jin Kim1, Hee Jin Yoo2, Kyung A Kim2, Jae Berm Park1

1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;
2Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea

Correspondence to: Kyo Won Lee
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-0842, Fax: +82-2-3410-0400 E-mail: kw1980.lee@gmail.com

Received: September 27, 2019; Revised: November 8, 2019; Accepted: November 14, 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Graft survival rate of kidney transplantation recipients improves after induction therapy. However, there is no conclusive evidence on which regimen is superior for deceased donor kidney transplantation (DDKT). This study aims at discussing effective induction therapy in DDKT.
Methods: Between 2003 and 2016, 395 DDKT recipients were divided into three groups following induction therapy. Recipients of the basiliximab group (n=184) received basiliximab (20 mg/kg) on days 0 and 4. Recipients of the low-dose rabbit anti-thymocyte globulin (rATG) group (n=113) received rATG (1.5 mg/kg) on days 0, 1, and 2, while those of the high-dose rATG group (n=98) received it for more than 4 days. We retrospectively reviewed and analyzed the clinical outcomes and adverse effects of induction therapy.
Results: Compared to other groups, the low-dose rATG group donors were older (P<0.001); rATG group donors had higher serum creatinine levels (P<0.001), and the basiliximab group showed a lower delayed graft function rate (P=0.004). In graft failure, the low-dose rATG group did not differ significantly from the basiliximab group (P=0.080), but was significantly different from the high-dose rATG group (P=0.004).
Conclusions: The low-dose rATG group had the best graft survival rate, although it had older donors and higher serum creatinine levels. Therefore, low-dose rATG may be considered an effective induction therapy in DDKT.

Keywords: Kidney transplantation, Immunosuppressive agent, Graft rejection

Supplementary information
Supplementary File