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Abstract: FR-PO836

Outcomes of Thymoglobulin vs. Basiliximab Induction in Simultaneous Heart Kidney Transplant: A Single-Center Experience

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Bhargava, Juhi, University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
  • McGill, Rita L., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
  • Krishnamoorthy, Sambhavi, University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
  • Josephson, Michelle A., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
  • Kyeso, Yousuf, University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
Background

Simultaneous heart kidney transplants (SHK) are less common than kidney-only transplants due to the complex medical and surgical factors involved. Optimal induction immunosuppressive therapy is not known. Ariyamuthu et al. showed no statistically significant difference in mortality or infection rates based on induction agent. Data are sparse on best induction therapy for SHK patients so we studied outcomes associated with different induction therapy approaches.

Methods

From 2008-2021, 55 SHK with either Thymoglobulin (r-ATG) or Basiliximab (IL2rAb) induction were performed at our center. We retrospectively reviewed those patient records and compared renal outcomes, infection rates, and mortality over a 12-month period post transplantation. Continuous variables and outcomes were compared using Student’s t-test, and categorical variables and outcomes were compared using chi-squared tests.

Results

Baseline characteristics are summarized in figure 1. At 12 months, average GFR was 55.4 with r-ATG and 55.1 with IL2rAb (P=0.96). One year mortality was 9.4% with r-ATG and 21.7% with IL2rAb (P=0.20). Delayed graft function (DGF) was 18.8% with r-ATG and 34.8% with IL2rAb (P= 0.2). One-year rejection rate was 25.0% with r-ATG and 17.4% with IL2rAb (P=0.5). BK viremia was 40.6% with r-ATG and 39.1% with IL2rAb (P= 0.9). CMV viremia was 34.3% with r-ATG and 17.4% with IL2rAb (P=0.2). Infection related hospitalization rates in r-ATG and IL2rAb were 43.8% and 39.1% (P= 0.7).

Conclusion

In this single-center cohort, we observed roughly 50% lower mortality and DGF in SHK recipients when r-ATG was used, compared to IL2rAb, but the rates of CMV viremia were nearly twice as high and rejection over the first year was 30% greater. These differences were not statistically significant but provide an early signal for differential effects of induction strategy. Further work is needed to clarify optimal approach to this increasingly performed, lifesaving multi-organ transplant