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Role and comparison of induction therapy in renal re-transplantation

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Author:
No author available
Journal Title:
Chinese Journal of Organ Transplantation
Issue:
11
DOI:
10.3760/cma.j.issn.0254-1785.2011.11.003
Key Word:
肾移植;再手术;抗体;治疗结果;Kidney transplantation;Reoperation;Antibodies;Treatment outcome

Abstract: Objective To summarize the clinical experience of antibody induction therapy in renal re-transplantations and compare the outcomes among different antibodies.Methods We retrospectively investigated 39 recipients after renal re-transplantations in our center.According to the induction agents,patients were divided into three groups as follows:basiliximab (Bax) group (patients treated with Bax,n =12),T lymphocyte polyclonal antibody (ALG) group (patients treated with ALG,n =19) and thymoglobuline (ATG) group (patients treated with ATG,n =8).Incidence of acute rejection,graft loss and cytomegalovirus infection was analyzed,as well as graft survival rate and serum creatinine one year after transplantation.Results Acute rejection occurred in 5 patients of Bax group (5/12,41.7 %),in 9 patients of ALG group (9/19,47.4 %) and 1 patient of ATG group (1/8,12.5 %).The acute rejection rate was similar in Bax and ALG groups,but significantly decreased in ATG group.The 1-year survival rate of re-transplant recipients was 84.6 %.There were no significant differences in 1-year survival rote between Bax group and ALG group (82.4 % vs 80.5 %),while ATG group showed higher survival rate (90.8 %).The renal function in ATG group was improved at 1st year after re-transplantation:serum creatinine (121.3 ± 22.6) μmol/L vs (176.8±43.5)μmol/L in Bax group and (195.4 ± 35.2) μmol/L in ALG group respectively.There were 2patients with CMV infection in Bax group,3 patients in ALG group and 2 patients in ATG group.There was no significant increase in infection incidence between ATG group and Bax or ALG groups during the follow-up period.Conclusion Retrospective analysis from monocenter and small samples indicated that ATG induction treatment seems to be effective in decreasing acute rejection risk andachieving better outcomes in the renal re-transplant recipients without increased CMV infection incidence.

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