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Kidney Transplant Induction Therapies Compared

Researchers find that antithymocyte globulin reduces acute rejection better than basiliximab

WEDNESDAY, Nov. 8 (HealthDay News) -- In patients who receive kidney transplants from deceased donors, induction therapy with antithymocyte globulin reduces the incidence and severity of acute rejection compared to basiliximab, but not the incidence of delayed graft function, according to a report in the Nov. 9 issue of the New England Journal of Medicine.

Daniel C. Brennan, M.D., of the Washington University School of Medicine in St. Louis, and colleagues compared one-year outcomes in 141 patients who received rabbit antithymocyte globulin and 137 patients who received basiliximab. All patients had received a renal transplant from a deceased donor and were at high risk for acute rejection or delayed graft function.

The antithymocyte globulin group had lower incidences of acute rejection than the basiliximab group (15.6 percent versus 25.5 percent) and of acute rejection that required treatment with antibody (1.4 percent versus 8 percent). But both groups had similar incidences of graft loss (9.2 percent versus 10.2 percent), delayed graft function (40.4 percent versus 44.5 percent) and death (4.3 percent versus 4.4 percent).

"Graft survival and function were not altered at 12 months, but for long-term survival and function, only time will tell," states the author of an accompanying editorial. "Some centers may switch to antithymocyte globulin, but both treatments…will continue to have their supporters."

The study was supported by SangStat Medical Corp. and by Genzyme.

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