Impact of Induction Therapy on Preventing Early Acute Kidney Allograft Rejection: A Single-Center Experience Study
JOURNAL OF CLINICAL PRACTICE AND RESEARCH, cilt.47, sa.2, ss.203-210, 2025 (ESCI, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 47 Sayı: 2
- Basım Tarihi: 2025
- Doi Numarası: 10.14744/cpr.2025.15284
- Dergi Adı: JOURNAL OF CLINICAL PRACTICE AND RESEARCH
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.203-210
- Ankara Üniversitesi Adresli: Evet
Özet
Objective: Acute rejection infrequently occurs among immunologically low-risk recipients within the first few weeks after transplantation, and the role of induction treatment in the frequency of acute rejection and graft loss remains debatable. Materials and Methods: This retrospective study analyzed 208 kidney transplant recipients with low immunological risk, defined by living donortransplantation, no priortransplantation history, absence of preformed anti-HLA antibodies, and a negative lymphocyte crossmatch prior to transplantation. Demographic data, immunologic characteristics, and graft functions were analyzed concerning early acute rejection history. Results: Fifteen patients (7.2%) experienced acute rejection within two weeks post- transplantation. No correlation was found between the number of HLA mismatches and induction treatment with early acute rejection. The cumulative incidences of acute rejection in the no-induction and basiliximab groups were comparable at 7.8% and 6.4%, respectively. Donor age was markedly higher, and the tacrolimus trough level on the seventh day post-transplantation was significantly lower in the early acute rejection group; however, the significance was lost after adjustment. The incidence of graft loss was higher in the early acute rejection cohort than in the no-rejection cohort (33.3% vs. 3.1%, p<0.001). Early acute rejection was the only independent risk factor for graft failure (HR 10.286, CI 1.944-54.409, p=0.006). Conclusion: Acute rejection within two weeks post-transplantation has been associated with suboptimal graft function in recipients with low immunological risk. Basiliximab does not provide additional advantages in preventing early acute rejection in patients with a low immunological risk on tacrolimus-based immunosuppression.