Premium
Efficacy of induction therapy on acute rejection and graft outcomes in African American kidney transplantation
Author(s) -
Hammond Emily B.,
Taber David J.,
Weimert Nicole A.,
Egidi Maria F.,
Bratton Charles F.,
Lin Angello,
McGillicuddy John W.,
Chavin Kenneth D.,
Baliga Prabhakar K.
Publication year - 2010
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.00974.x
Subject(s) - thymoglobulin , medicine , kidney transplantation , induction therapy , transplantation , retrospective cohort study , gastroenterology , surgery , chemotherapy
Hammond EB, Taber DJ, Weimert NA, Egidi MF, Bratton CF, Lin A, McGillicuddy JW, Chavin KD, Baliga PK. Efficacy of induction therapy on acute rejection and graft outcomes in African American kidney transplantation.
Clin Transplant 2010: 24: 40–47. © 2009 John Wiley & Sons A/S. Abstract: Background: African Americans (AA) have higher rejection rates and poorer graft outcomes compared to non‐AAs. Induction therapy is yet unproven in this high risk population. Methods: This retrospective study compared the efficacy of induction therapy [IL‐2 receptor antibodies (IL2RA) or thymoglobulin] vs. no induction. Results: One hundred and seventy‐five AA patients were included in this analysis. Patients were well matched for demographic and immunologic characteristics in the non‐induction and IL2RA induction groups; the Thymoglobulin induction group had significantly higher risk patients. Significantly fewer episodes of acute rejection occurred at one yr in patients treated with thymoglobulin and IL2RA vs. no induction (18% vs. 47%, p = 0.003, 26% vs. 47%, p = 0.02). Three yr graft survival was significantly improved in the IL2RA group compared to the non‐induction group (85% vs. 68%, p = 0.032). Despite the thymoglobulin group being at high risk, they had similar graft survival rates compared to both the IL2RA group (76% vs. 85%, p = 0.18) and the non‐induction group (76% vs. 68%, p = 0.48). Multivariate analysis demonstrated that induction therapy (combining IL2RA and thymoglobulin) independently reduced the risk of both acute rejection and graft loss. Conclusion: The use and type of induction therapy in AA patients significantly reduces acute rejection rates and may improve long‐term graft outcomes in AA patients.