Induction therapy: clinical and quality of life outcomes in aged renal transplant recipients

Background One primary purpose of transplant is to improve quality of life ( QOL ) in renal transplant recipients ( RTR s) ≥50 yr of age, where death with a functioning graft limits life years gained. We aimed to determine the impact of induction therapy, with its subsequent effects on rejection, infection, and readmissions, on QOL . Methods Subanalysis of patients ≥50 yr of age that participated in a single‐center, prospective, risk‐stratified, randomized, open‐label study. Two hundred RTR s ≥ 50 yr of age. Interventions All patients received either rabbit antithymocyte globulin ( rATG ) or interleukin 2 receptor antagonists ( IL ‐2 RA ) in addition to tacrolimus ( FK ), mycophenolate mofetil ( MMF ), and corticosteroids in a randomized fashion. Outcome analyses included safety, efficacy, and QOL . Results Results reported 1 yr post‐transplant. Of 111 patients ≥50 yr old, 48 received IL ‐2 RA and 63 received r ATG . Baseline characteristics were similar between groups. Patients that received r ATG had a trend toward lower acute rejection rates, fewer readmissions, and fewer supratherapeutic tacrolimus troughs, with similar rates of infections. QOL analysis demonstrated patients that received r ATG were significantly more likely to have improvements in physical and social functioning after transplant. Conclusions Contrary to the common practice, T ‐cell depletion in recipients ≥50 yr of age may be beneficial.