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ORIGINAL ARTICLE
Year : 2019  |  Volume : 13  |  Issue : 2  |  Page : 104-109

Basiliximab induction in living donor kidney transplant with tacrolimus-based triple immunosuppression


1 Department of Nephrology and Kidney Transplantation, Medanta Kidney and Urology Institute, Medanta-Medicity, Gurgaon, Haryana, India
2 Department of Nephrology, Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, Jammu and Kashmir, India

Correspondence Address:
Dr. Shyam Bihari Bansal
Department of Nephrology and Kidney Transplantation, Medanta Kidney and Urology Institute, Medanta-Medicity, Sector 38, Gurgaon - 122 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijot.ijot_81_18

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Introduction: Interleukin-2 receptor antagonists are recommended to reduce the risk of acute rejection (AR) in kidney transplant. This prospective study was undertaken to compare the incidence of AR with basiliximab induction as compared to no induction in first kidney recipients of living donors with tacrolimus (TAC)- and mycophenolate mofetil-based triple immunosuppression at 6 months. Methods: Two hundred and sixty patients were included in the study, 202 in the basiliximab group and 58 in the no induction group. Patients in the basiliximab group received two doses of 20 mg each on day 0 and day 4. The primary outcome was biopsy-proven AR at 6 months, and the secondary outcomes were incidence of infections and other adverse events along with graft and patient survival at the end of follow-up. All patients were followed up for a period of minimum 6 months. Results: There was no difference in baseline characteristics between the groups except higher human leukocyte antigen mismatch in the basiliximab group (3.80 ± 1.50 vs. 2.81 ± 1.53, P = 0.002). Forty-two (20.8%) patients in the basiliximab group developed AR at 6 months as compared to 10 (17.2%) in the no induction group (P = 0.55). There was no difference in adverse events between the groups. At a median follow-up of 1 year, graft survival (97% vs. 98.3%, P = 0.60) and patient survival (99% vs. 98.2%, P = 0.87) were also similar between the basiliximab and no induction groups, respectively. Conclusions: This study suggests that there is no advantage of using basiliximab induction in reducing AR in first kidney recipients of living donors in TAC-based triple immunosuppression.


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