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

대한이식학회지 2019년 33권 4호 p.118 ~ 127
 ( Jeong Eun-Sung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery

이교원 ( Lee Kyo-Won ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김상진 ( Kim Sang-Jin ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Yoo Hee-Jin ) - Samsung Medical Center Biostatistics and Clinical Epidemiology Center
김경아 ( Kim Kyung-A ) - Samsung Medical Center Biostatistics and Clinical Epidemiology Center
박재범 ( Park Jae-Berm ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery

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.

키워드

Kidney transplantation; Immunosuppressive agent; Graft rejection
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