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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Considering the importance of minimizing delayed graft function (DGF), immunosuppressive strategies that reduce early ischemia-reperfusion injury could play a critical role not only in improving patient outcomes but also in informing allocation decisions in deceased donor kidney transplantation (DDKT). Thymoglobulin has been beneficial in the allograft recovery by delaying the exposure to tacrolimus in DDKT patients, but the best timing of tacrolimus is uncertain. Therefore, the timing of tacrolimus initiation has implications for optimizing kidney allocation strategies.
We performed 126 DDKT recipients with thymoglobulin among 395 KTRs from September, 2013 to September, 2020. This study aims to evaluate the impact of early versus delayed tacrolimus initiation on clinical outcomes in DDKT with thymoglobulin induction. We divided them into two groups: early tacrolimus initiation (n=33) and delayed tacrolimus initiation (n=93) based on the tacrolimus timing. We investigated allograft function at the early and late period of time after KT, the rate of DGF, acute rejection within 1 year after KT, infection, death-censored graft survival, and patient survival.
The baseline characteristics were not different between them. There were no significant differences of human leukocyte antigen mismatch numbers, the proportion of patients with panel reactive antibody > 50%, or the presence of preformed donor-specific antibody (DSA). The delayed initiation group had a higher incidence of DGF compared to the early initiation group. Allograft function was worse in the early initiation group than in the delayed group at the early post-transplant period, but this difference disappeared in the later post-transplant period. Delayed initiation group showed a higher frequency of acute rejection within 1 year after KT, the development of de novo DSA, and lower death-censored graft survival rate compared to the delayed initiation group. There were no significant differences in the development of infection like cytomegalovirus or BK virus, and patient survival rate between them.
Delayed initiation of tacrolimus in DDKT recipients treated with thymoglobulin resulted in better allograft function during the only early post-transplant period compared to early initiation. However, delayed tacrolimus initiation was associated with higher rates of acute rejection and reduced graft survival. Therefore, early tacrolimus initiation not only benefits individual transplant outcomes but may also support more efficient and equitable kidney allocation by enhancing graft viability and maximizing utilization of donated organs.
