THE DILEMMA OF INDUCTION IMMUNOSUPPRESSION IN LOW IMMUNOLOGICAL RISK KIDNEY TRANSPLANT RECIPIENTS- A PROSPECTIVE RANDOMISED STUDY FROM EASTERN INDIA COMPARING BASILIXIMAB VERSUS NO INDUCTION IMMUNOSUPPRESSION

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https://storage.unitedwebnetwork.com/files/1099/31450560675543c0ec3ed3d66c77641c.pdf

Abstract Title *

THE DILEMMA OF INDUCTION IMMUNOSUPPRESSION IN LOW IMMUNOLOGICAL RISK KIDNEY TRANSPLANT RECIPIENTS- A PROSPECTIVE RANDOMISED STUDY FROM EASTERN INDIA COMPARING BASILIXIMAB VERSUS NO INDUCTION IMMUNOSUPPRESSION

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Co-author 1

Varun Gosain drvarunnephrology@gmail.com Fmri gurgaon Nephrology and kidney transplant Gurugram India *

Co-author 2

Sb Rout drvarunnephrology@gmail.com Scb cuttack Nephrology Cuttack India -

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Introduction

Induction immunosuppression decreases the risk for acute rejection and improves graft outcomes in kidney transplant recipients but its role in low immunological risk group of patients is controversial. The objective of this study was to evaluate the impact of induction with basiliximab versus no induction therapy on outcomes in low immunological risk kidney transplant recipients (KTRs).

Methods

This study was conducted between May 2016 to May 2022 in a tertiary care centre in eastern India. It was a prospective study where two groups of low immunological risk KTRs were identified, one who did not receive induction therapy and the other who received induction therapy with basiliximab. Low immunological risk KTRs was defined in this study as patients undergoing first transplant, panel reactive antibody <20% and human leucocyte antigen mismatches ≤3. Both the groups were comparable in baseline characteristics and risk factors for acute rejection.

Results

A total of 104 low immunological risk kidney transplant recipients were identified with 52 patients who did not receive induction therapy and another 52 patients who received basiliximab. Adjusted risk for delayed graft function was higher (OR 1.69, 95%CI 1.05-3.11, p=0.02) and one year acute rejection was found to be lower (OR 0.53, 95%CI 0.35- 1.08, p= 0.09) in the basiliximab group compared to the group of patients who did not receive induction therapy. Adjusted five year graft survival were similar in both groups. Adjusted patient death risk was found to be lower (HR 0.42, 95%CI 0.30- 0.74, p= 0.04) in the basiliximab group.

Conclusion

Perioperative induction with basiliximab in low immunological risk kidney transplant recipients had lower rejection and lower patient death risk.

Kewords