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Induction therapy may increase mortality risk for some simultaneous liver-kidney transplant patients
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SAN DIEGO — Induction therapy appears to increase the mortality risk among patients who had a simultaneous liver-kidney transplant and were on rabbit anti-thymocyte globulin, according to data presented at ASN Kidney Week 2018.
“The infection rate is higher with the [rabbit anti-thymocyte globulin] r-ATG group in comparison to the no-induction group, so simultaneous liver-kidney transplant patients are going to do better without induction therapy,” Suman Krishna Kotla, MD, said here.
Kotla and colleagues queried the Organ Procurement and Transplantation Network for a total of 3,388 adult patients who had a simultaneous liver-kidney transplant. The cohort was categorized into one of the following three groups according to the induction agent received: r-ATG; interleukin-2 receptor antagonists; and no-induction. All patients received the contemporary maintenance immunosuppression regimen of tacrolimus, mycophenolic acid and prednisone. The inverse probability weighting adjusted Cox proportional hazard analyses showed an increased mortality with r-ATG (HR=1.31), according to the researchers.
“We found no difference in the kidney or liver rejection at 6 months in all three groups, but in comparison to the no-induction group, the r-ATG group appeared to have a higher mortality risk, probably because of infectious complications,” Kotla said. – by Kristine Houck, MA, ELS, and Joe Gramigna
Reference:
AbdulRahim N, et al. Abstract SA-PO007. Presented at: ASN Kidney Week; Oct. 23-28, 2018; San Diego.
Disclosure: Kotla reports no relevant financial disclosures.