Abstract: SA-PO1161
Outcomes of Different Induction Therapies in ABO-Incompatible Renal Transplant Recipients in the Tacrolimus Era
Session Information
- Transplantation: Clinical - Rejection, Recurrent Disease, Incompatibility
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Soliman, Karim Magdy Mohamed, Medical University of South Carolina , Charleston, South Carolina, United States
- Daoud, Ahmed, Cairo University, Cairo, Egypt
- Ali, Hatem, Heartlands hospital, Birmingham, United Kingdom
- Rao, Vinaya, MUSC Transplant Center, Charleston, South Carolina, United States
- Fulop, Tibor, Medical University of South Carolina , Charleston, South Carolina, United States
- Elsayed, Ingi, university hospitals of north midlands, Stoke-on-trent, United Kingdom
Background
ABO-incompatible renal transplantation is emerging as a safe and potentially acceptable routine procedure; however, outcomes of different induction therapies in ABO-incompatible renal transplant recipients (RTRs) remain insufficiently explored in the tacrolimus era.
Methods
Using data from organ procurement and transplantation network, all ABO-incompatible RTRs maintained on tacrolimus based immunotherapy between 2000 and 2017 were retrospectively reviewed. Data including age, sex, gender, ethnicity, functional status, diabetes, body mass index, cold ischemia time, number of previous transplants, panel reactive antibodies, donor type, donor age, HLA-mismatches, number of acute rejection episodes, induction therapies, maintenance immunotherapy, recipients and graft survival were collected (Table 1). Based on induction therapies administered, RTRs were divided into 2 groups; anti-thymocyte globulin (ATG) or interleukin-2 receptor antagonist (IL-2RA). Inverse probability weights were used to adjust confounders among different groups using propensity score analysis. Cox hazard regression analysis for adjusted data and treatment effects model were used to assess outcomes.
Results
Out of 14,414 RTRs, 8844 received IL2-RA while 5570 received ATG for induction. There were no significant differences between the IL2-RA and ATG groups in terms of early post-operative acute rejection episodes (95% CI ranges from -0.007 to 1.008, P=0.8), overall acute rejection episodes (CI ranges from -32.5 to 3.1, P=0.107) or graft survival (CI ranges from -169.6 to 199.3, P=0.87). Mean graft survivals were similar (7.8 vs 7.5 years, p=0.8), as well (Figure 1,2,3).
Conclusion
In the tacrolimus era, ATG as compared to IL2-RA induction therapy does not have a favourable graft or survival outcomes in ABO-incompatible RTRs.