Comparison of induction therapy using anti-thymocyte globulin and using basiliximab for live donor kidney transplant recipients: A single-center, prospective, cohort study

Abstract

Objective: Acute rejections (ARs) have a negative impact on long-term graft survival and are the major predictor of chronic rejection. Induction therapy is used to reduce AR and prevent delayed graft function (DGF). Anti-thymocyte globulin (ATG) and basiliximab are mainly used for this purpose. In this prospective, cohort study, we analyzed and compared the safety and efficacy of ATG and basiliximab in induction therapy for live donor kidney transplant recipients. Methods: Graft survival, AR-free survival, renal function, DGF, and tolerability were compared in patients who underwent live donor transplantation between January 2014 and August 2014 at Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India. Results and Discussion: A total of 85 live donor kidney transplant recipients who enrolled were followed up for 12 months. The incidence of AR was greater in the basiliximab group, as compared with the ATG group (25.6% vs. 7.1%, p<0.05). The incidence of antibody-treated AR was also greater (18.6% vs. 2.4 %, p<0.05). Patient survival rate and graft survival rate were 95.2% and 92.9% in the ATG group, respectively, compared with 90.4% and 90.7% in the basiliximab group, respectively. The incidence of adverse events was higher in the ATG group compared with the basiliximab group (71.4% vs. 48.3%, p<0.05).Conclusion: The incidence of AR and antibody-treated AR was significantly higher in the basiliximab group than in the ATG cohort. However, ATG was associated with the significantly higher incidence of adverse events and leukopenia than basiliximab. Both the strategies were achieved similar patient and graft survival.