Effect of Interleukin-2 Receptor Antibody Induction Therapy on Survival in Renal Transplant Patients Receiving Tacrolimus

2020 ◽  
Vol 51 (5) ◽  
pp. 366-372
Author(s):  
Hatem Ali ◽  
Ajay Sharma ◽  
Ahmed Halawa
Keyword(s):  
Renal Transplant ◽  
Induction Therapy ◽  
Interleukin 2 ◽  
Receptor Blocker ◽  
Post Transplant ◽  
Transplant Patients ◽  
Induction Group ◽  
Significant Difference ◽  
Renal Transplant Patients ◽  
Standard Risk

Background: This study aims to assess outcomes of interleukin-2 (IL-2) receptor blocker induction therapy on allograft and patients’ outcomes in standard risk recipients in the tacrolimus era, analysing data form the British Renal Transplant Registry. Methods: The study population involved all standard-risk renal transplant patients from 2000 till 2015 who were registered in the UK transplant registry and followed up till May 2018. Standard risk transplants were defined as patients with <2DR mismatch, calculated reaction frequency <20%, live donors or donors after brain death and patients with no previous renal transplantation transplant. We used inverse probability weights to adjust different covariates between the groups. Cox regression analysis for adjusted data and treatment effects model were used to assess outcomes. Results: In all, 3,597 renal transplant patients were included in the study. Two groups were identified; induction group (n = 2,858) which included patients who received IL-2 receptor blocker induction therapy and the no-induction group (n = 739). There was no significant difference between both groups in terms of estimated glomerular filtration rate (eGFR) rate at 1-year post-transplant (correlation co-efficient = 1.224, 95% CI ranges from –0.347 to 2.796). Average eGFR was 59.922 mL/min/1.73 m2 in the induction group (SD 29.171) and 64.557 mL/min/1.73 m2 in the no-induction groups (SD 46.763). There was no significant difference between both groups regarding graft survival at 5 years post-transplant (hazard ratio [HR] 0.944, 95% CI ranges from 0.599 to 1.485, p = 0.804), patient survival at 5 years post-transplant (HR 0.809, 95% CI ranges from 0.477 to1.372, p = 0.433). Conclusion: In the standard risk renal transplant population, the IL2 receptor blocker induction regimen does not affect eGFR at 1 year or renal and graft outcomes at 5 years.

The Economic Burden of Post-Transplant Events in Renal Transplant Patients in Spain (The PORTRAIT Study)

2012 ◽  
Vol 94 (10S) ◽  
pp. 809 ◽  
Author(s):  
J. Grinyo ◽  
J. Pascual ◽  
J. Campistol ◽  
A. Andrés ◽  
J. Sánchez Plumed ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Economic Burden ◽  
Post Transplant ◽  
Transplant Patients ◽  
Renal Transplant Patients

scholarly journals Comparison of total joint arthroplasty outcomes between renal transplant patients and dialysis patients—a meta-analysis and systematic review

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jiayi Li ◽  
Mingyang Li ◽  
Bo-qiang Peng ◽  
Rong Luo ◽  
Quan Chen ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Sample Size ◽  
Total Joint Arthroplasty ◽  
Small Sample Size ◽  
Joint Arthroplasty ◽  
Small Sample ◽  
Dialysis Patients ◽  
Transplant Patients ◽  
Significant Difference ◽  
Renal Transplant Patients

Abstract Objectives End-stage renal disease (ESRD) patients are at an increased risk of needing total joint arthroplasty (TJA); however, both dialysis and renal transplantation might be potential predictors of adverse TJA outcomes. For dialysis patients, the high risk of blood-borne infection and impaired muscular skeletal function are threats to implants’ survival, while for renal transplant patients, immunosuppression therapy is also a concern. There is still no high-level evidence in the published literature that has determined the best timing of TJA for ESRD patients. Methods A literature search in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to November 2019) was performed to collect studies comparing TJA outcomes between renal transplant and dialysis patients. Two reviewers independently conducted literature screening and quality assessments with the Newcastle-Ottawa Scale (NOS). After the data were extracted, statistical analyses were performed. Results Compared with the dialysis group, a lower risk of mortality (RR = 0.56, Cl = [0.42, 0.73], P < 0.01, I2 = 49%) and revision (RR = 0.42, CI = [0.30, 0.59], P < 0.01, I2 = 43%) was detected in the renal transplant group. Different results of periprosthetic joint infection were shown in subgroups with different sample sizes. There was no significant difference in periprosthetic joint infection in the small-sample-size subgroup, while in the large-sample-size subgroup, renal transplant patients had significantly less risk (RR = 0.19, CI = [0.13, 0.23], P < 0.01, I2 = 0%). For dislocation, venous thromboembolic disease, and overall complications, there was no significant difference between the two groups. Conclusion Total joint arthroplasty has better safety and outcomes in renal transplant patients than in dialysis patients. Therefore, delaying total joint arthroplasty in dialysis patients until renal transplantation has been performed would be a desirable option. The controversy among different studies might be partially accounted for that quite a few studies have a relatively small sample size to detect the difference between renal transplant patients and dialysis patients.

EXPERIENCE WITH TWO-DOSE DACLIZUMAB INDUCTION THERAPY IN PEDIATRIC RENAL TRANSPLANT PATIENTS

2010 ◽  
Vol 90 ◽  
pp. 1053
Author(s):  
S. Sevmis ◽  
A. Akdur ◽  
S. Aktas ◽  
E. Baskin ◽  
H. Karakayali ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Induction Therapy ◽  
Transplant Patients ◽  
Pediatric Renal Transplant ◽  
Renal Transplant Patients

scholarly journals Implication of interleukin-2 receptor antibody induction therapy in standard risk renal transplant in the tacrolimus era: a meta-analysis

2019 ◽  
Vol 12 (4) ◽  
pp. 592-599 ◽  
Author(s):  
Hatem Ali ◽  
Atif Mohiuddin ◽  
Ajay Sharma ◽  
Ihab Shaheen ◽  
Jon Jin Kim ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Graft Survival ◽  
Induction Therapy ◽  
Meta Analysis ◽  
Interleukin 2 ◽  
Forest Plot ◽  
Renal Transplant Recipients ◽  
Number Of Patients ◽  
Antibody Induction ◽  
Standard Risk

Abstract Background Interleukin-2 (IL-2) antagonist has been used as an induction therapy in many centres in calcineurin inhibitor-sparing regimens. Tacrolimus has overwhelmingly replaced cyclosporine in the maintenance immunosuppressive protocols in many transplant centres. The aim of our study and meta-analysis is to explore the effect of IL-2 induction therapy on the rate of rejection and patient and graft survival in standard-risk renal transplant patients with tacrolimus-based maintenance immunotherapy. Secondary aims included assessment of the effect of IL-2 induction therapy on creatinine change and the risk of cytomegalovirus (CMV) infection. Methods We conducted a systematic review in different databases to identify studies and research work that assessed the effect of IL-2 antibody induction therapy on renal transplant outcomes. Inclusion criteria for our meta-analysis were all studies that compared IL-2 induction therapy with placebo or no induction therapy in standard-risk renal transplant recipients on tacrolimus-based maintenance immunosuppressive therapy. Data collected were the name of the first author, journal title, year of publication, country where the study was conducted, number of patients in the IL-2 induction therapy arm and in the placebo arm, number of patients who had biopsy-proven rejection and graft survival in each arm. A random effects model was used for the meta-analysis. Results Of the 470 articles found in different databases, 7 were included in the meta-analysis. Forest plot analysis for rate of rejection during the follow-up period post-transplant showed no significant difference between the groups. There was no evidence of heterogenicity between included studies (I2 = 21.8%, P = 0.27). The overall risk difference was −0.02 [95% confidence interval (CI) −0.05–0.01]. A random effects meta-analysis for patient and graft survival was performed using forest plot analysis and showed no significant effect of IL-2 receptor (IL-2R) antibody induction on patient or graft survival compared with placebo. The overall risk difference was −0.01 (95% CI −0.04–0.01) and 0.00 (95% CI −0.00–0.01), respectively. Three of the included studies showed no effect of basiliximab on creatinine change, two showed no effect on risk of CMV infection and two showed less risk of post-transplant diabetes in the basiliximab group. Conclusion IL-2R antibody induction therapy has no significant effect on the rate of rejection or patient or graft survival in standard-risk renal transplant recipients on tacrolimus-based maintenance immunotherapy. More randomized controlled studies are needed.

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