Efficacy and safety of thymoglobulin and basiliximab in kidney transplant patients at high risk for acute rejection and delayed graft function

Exp Clin Transplant. 2013 Aug;11(4):310-4. doi: 10.6002/ect.2012.0103. Epub 2012 Nov 1.

Abstract

Objectives: To compare the efficacy and safety of thymoglobulin compared with basiliximab in patients who had kidney transplants and are at high risk for acute rejection and delayed graft function.

Materials and methods: A retrospective review of patients who had 1 or more risk factors for acute rejection and delayed graft function and who were given either thymoglobulin or basiliximab for induction therapy. Incidences of acute rejection, antibody-treated acute rejection, delayed graft function, chronic rejection, cancer, infection, leucopenia, and thrombocytopenia were compared between thymoglobulin and basiliximab groups. Serum creatinine levels within 1 year and long-term graft and patient survival also were compared.

Results: A total of 327 patients were included. Incidences of acute rejection, antibody-treated acute rejection, delayed graft function, and chronic rejection were significantly lower in the thymoglobulin group than in the basiliximab group (P < .05). Serum creatinine levels were lower in the thymoglobulin group on postoperative days 7, 14, and 30 (P < .05). There were no statistically significant differences regarding long-term graft and patient survival, cancer, or total infection rate between the groups. Incidences of Cytomegalovirus infection, leucopenia, and thrombocytopenia were significantly higher in the thymoglobulin group (P < .05).

Conclusions: Thymoglobulin may improve short-term outcomes, compared with basiliximab, in patients who had kidney transplants and are at high risk for acute rejection and delayed graft function. However, long-term outcomes are similar with thymoglobulin and basiliximab.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Antilymphocyte Serum / adverse effects
  • Antilymphocyte Serum / therapeutic use*
  • Basiliximab
  • Biomarkers / blood
  • Chi-Square Distribution
  • China / epidemiology
  • Chronic Disease
  • Creatinine / blood
  • Delayed Graft Function / blood
  • Delayed Graft Function / epidemiology
  • Delayed Graft Function / mortality
  • Delayed Graft Function / prevention & control*
  • Female
  • Graft Rejection / blood
  • Graft Rejection / epidemiology
  • Graft Rejection / immunology
  • Graft Rejection / mortality
  • Graft Rejection / prevention & control*
  • Graft Survival / drug effects*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Incidence
  • Kaplan-Meier Estimate
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / mortality
  • Male
  • Middle Aged
  • Recombinant Fusion Proteins / adverse effects
  • Recombinant Fusion Proteins / therapeutic use*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antilymphocyte Serum
  • Biomarkers
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Basiliximab
  • Creatinine
  • thymoglobulin