Should heart, lung, and liver transplant recipients receive immunosuppression induction for kidney transplantation?

Published

Journal Article

As the outcomes of heart, liver, and lung transplantation continue to improve, more patients will present for subsequent renal transplantation. It remains unclear whether these patients benefit from induction immunosuppression. We retrospectively reviewed induction on solid organ graft recipients who underwent renal transplant at our center from January 1, 1995 to March 30, 2007. Induction and the non-induction groups were compared by univariate and Kaplan-Meier analyses. There were 21 patients in each group, with mean follow-up of 4.5-6.0 years. Forty-seven percent of patients receiving induction had a severe post-operative infection, compared with 28.6% in the non-induction group (p = NS). The one yr rejection rate in the induction group was 9.5% compared with 14.3% for non-induction (p = NS). One-yr graft survival was 81.0% and 95.2% in the induction and non-induction group (p = NS). In summary, there is a trend toward lower patient and graft survival among patients undergoing induction. These trends could relate to selection bias in the decision to prescribe induction immunosuppression, but further study is needed to better define the risks and benefits of antibody-induction regimens in this population.

Full Text

Duke Authors

Cited Authors

  • Ranney, DN; Englesbe, MJ; Muhammad, W; Al-Holou, SN; Park, JM; Pelletier, SJ; Punch, JD; Lynch, RJ

Published Date

  • January 2010

Published In

Volume / Issue

  • 24 / 1

Start / End Page

  • 67 - 72

PubMed ID

  • 19222505

Pubmed Central ID

  • 19222505

Electronic International Standard Serial Number (EISSN)

  • 1399-0012

International Standard Serial Number (ISSN)

  • 0902-0063

Digital Object Identifier (DOI)

  • 10.1111/j.1399-0012.2009.00973.x

Language

  • eng