Interleukin-2 receptor antagonist compared with antithymocyte globulin induction therapy in kidney transplantation from donors after cardiac death

Abstract

Aims The aim of this study was to compare the efficacy and safety of induction therapy using the interleukin-2 receptor antagonist (IL-2RA) with antithymocyte globulin (ATG) under a tacrolimus-based immunosuppression regimen in kidney transplantation from donors after cardiac death. Methods It was a single-centre, retrospective, cohort study design to evaluate the efficacy and safety of IL-2RA vs. ATG induction therapy in adult renal transplant recipients from donors after cardiac death. The primary end-point was the incidence of biopsy-proven acute rejection (BPAR) at 6 months, and the secondary end-point included the incidence of delayed graft function (DGF), the renal function, and the patient and graft survival at 6 months. The safety end-point was the incidence of infectious complications. Results A total of 132 patients (n = 37 in the IL-2RA group and n = 95 in the ATG group) were enrolled from March 2013 to April 2014. The BPAR at 6 months was similar between the two groups (IL-2RA vs. the ATG group, 5.4% vs. 12.6%, respectively, p = 0.228). There were no differences in the DGF, renal function at 1 and 3 months, and the patient and graft survival at 6 months between the two groups, but the renal function at 6 months in the IL-2RA group was superior to that of the ATG group (p = 0.02). The IL-2RA group experienced less infection than the ATG group (p = 0.025). Conclusions The efficacy of IL2-RA and ATG induction under a tacrolimus-based immunosuppression regimen in low-risk DCD transplantation did not differ, but the safety of the IL2-RA induction was better than that of the ATG induction.