Effect of induction therapy in kidney transplantation in sensitive patients: analysis of risks and benefits.
J Bras Nefrol
; 38(1): 82-9, 2016 Mar.
Article
em En, Pt
| MEDLINE
| ID: mdl-27049369
ABSTRACT
INTRODUCTION:
Sensitization is associated with worse clinical outcomes after kidney transplantation (KT), including increased incidence of delayed graft function, acute rejection (AR) and graft loss.OBJECTIVES:
To evaluate 1-year efficacy and safety outcomes in sensitized KT recipients receiving antithymocyte globulin (ATG) induction and compare them to non-sensitized patients.METHODS:
Deceased donors KT recipients transplanted between January 1998 and December 2009 were divided into 5 groups control group 1 -n = 89, PRA negative, without induction therapy; control group 2 - n = 94, PRA negative, basiliximab induction; control group 3 - n = 81, PRA negative, ATG induction; test group 4 - n = 64, PRA 1-49%, ATG induction; test group 5 -n = 118, PRA ≥ 50%, ATG induction.RESULTS:
There was no difference in the incidence of AR among patients sensitized and non-sensitized, except for group 1, with highest incidence of AR (20.2%,p = 0.006 vs. Group 4 and p = 0.001 vs. group 5). Sensitized patients induced with ATG had higher incidence of citomegalovirus infection when compared with group 2 (26.6% and 14.4% vs. 2.1%). There were no differences in graft and patient survivals. In multivariable analysis, PRA > 50% and ATG induction were not associated with graft loss, death or death-censored graft loss.CONCLUSION:
Sensitized patients induced with ATG presented similar or lower incidence of AR when compared with non-sensitized patients not induced. Besides, these patients had similar safety profile and graft and patient survivals at 1 year.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Rim
/
Rejeição de Enxerto
/
Sobrevivência de Enxerto
/
Imunossupressores
/
Soro Antilinfocitário
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
/
Pt
Ano de publicação:
2016
Tipo de documento:
Article