Basiliximab is associated with a lower incidence of De novo donor-specific HLA antibodies in kidney transplant recipients: A single-center experience

Jarmi, Tambi; Abdelmoneim, Yousif; Li, Zhuo; Jebrini, Abdullah; Elrefaei, Mohamed

doi:10.1016/j.trim.2022.101778

Cited by 5 publications

(7 citation statements)

References 26 publications

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“…9 In the study by Jarmi and colleagues, all KTRs were maintained on tacrolimus and mycophenolic acid, but tacrolimus levels and changes to maintenance immunosuppression were not reported. 10 In both studies, dnDSAs reported in the ALZ and ATG groups were fairly evenly dispersed between Class I and Class II, similar to our ALZ group. 9,10 Our ATG group, however, had a higher percentage of Class II dnDSAs, which has been associated with poor graft outcomes.…”

Section: Discussionsupporting

confidence: 82%

“…10 In both studies, dnDSAs reported in the ALZ and ATG groups were fairly evenly dispersed between Class I and Class II, similar to our ALZ group. 9,10 Our ATG group, however, had a higher percentage of Class II dnDSAs, which has been associated with poor graft outcomes. 11 There were a significantly higher number of KTRs with human leukocyte antigen (HLA) mismatch of five to six in the ATG group, which is an independent risk factor for developing Class II dnDSAs.…”

Section: Discussionsupporting

confidence: 82%

“…However, in the study by Bath and colleagues, nearly 80% of the ATG group was receiving steroids 9 . In the study by Jarmi and colleagues, all KTRs were maintained on tacrolimus and mycophenolic acid, but tacrolimus levels and changes to maintenance immunosuppression were not reported 10 . In both studies, dnDSAs reported in the ALZ and ATG groups were fairly evenly dispersed between Class I and Class II, similar to our ALZ group 9,10 .…”

Section: Discussionsupporting

confidence: 66%

“…Two singlecenter studies compared incidence of dnDSA development between ALZ, ATG, and basiliximab induction in KTRs. 9,10 Both of these studies found similar outcomes with ALZ being associated with a higher rate of dnDSA development compared to ATG. However, in the study by Bath and colleagues, nearly 80% of the ATG group was receiving steroids.…”

Section: Discussionmentioning

confidence: 74%

“…Although not statistically significant, the ALZ group had nearly double the percentage of recipients with dnDSAs compared to the ATG group. Two single‐center studies compared incidence of dnDSA development between ALZ, ATG, and basiliximab induction in KTRs 9,10 . Both of these studies found similar outcomes with ALZ being associated with a higher rate of dnDSA development compared to ATG.…”

Section: Discussionmentioning

confidence: 98%

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Alemtuzumab versus anti‐thymocyte globulin in kidney transplant recipients receiving a rapid steroid withdrawal regimen

Rikard,

Chargualaf,

Coulter

et al. 2024

Clinical Transplantation

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IntroductionIn kidney transplant recipients (KTRs), steroid‐free maintenance regimens are used to minimize the negative impact of steroid use. Studies comparing alemtuzumab (ALZ) and anti‐thymocyte globulin (ATG) with rapid steroid withdrawal are limited. The aim of this study was to assess a composite outcome of incidence of de novo donor specific antibodies (dnDSAs), biopsy proven rejection (BPAR), graft failure, or death in KTRs receiving ALZ or ATG with a steroid‐free maintenance regimen.MethodsA single‐center, retrospective cohort study was conducted in adult KTRs who underwent rapid steroid withdrawal. There were two cohorts, KTRs who received induction with ALZ compared to ATG. The primary composite outcome was incidence of dnDSAs, BPAR, graft failure, or death. Secondary outcomes included renal function, cytomegalovirus (CMV) and BK viremia, and leukopenia.ResultsTwo hundred twenty‐five KTRs were included where 146 received ALZ and 79 received ATG. The Cox proportional hazard of the primary composite outcome in the ALZ compared to ATG group was not significant (unadjusted model HR 1.37, 95% CI .74–2.55). Individual incidences of composite outcome were similar. There was a difference in estimated glomerular filtration rate at 12 months post‐transplant (55.7 vs. 62.3 mL/min/1.73m2, p = .03) and leukopenia at 3 months (3.7 vs. 4.2 × 109/L, p = .03). Other secondary outcomes were similar.ConclusionsThere was no difference in composite outcome for dnDSAs, BPAR, graft failure, and death.

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