Induction therapy in kidney transplant recipients

Julie Boucquemont (1) , Yohann Foucher (1, 2) , Christophe Masset (2, 3) , Christophe Legendre (4) , Anne Scemla (4) , Fanny Buron (5) , Emmanuel Morelon (5) , Valérie Garrigue (6) , Vincent Pernin (6) , Laetitia Albano (7) , Antoine Sicard (7) , Sophie Girerd (8) , Marc Ladrière (8) , Magali Giral (2, 3, 9) , Jacques Dantal (2, 3)

1 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch
2 CHU Nantes - Centre Hospitalier Universitaire de Nantes
3 ITUN - Institut de transplantation urologie-néphrologie
4 Hôpital Necker - Enfants Malades [AP-HP]
5 Hôpital Edouard Herriot [CHU - HCL]
6 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
7 Département de Néphrologie - Hôpital Pasteur [Nice]
8 Service de Transplantation Rénale [CHU Brabois]
9 Fondation, Centre d’Investigation Clinique en Biothérapie - Réseau CENTAURE [CHU Nantes]

Background There is extensive literature with comparisons between Anti-Thymocyte Globulin (ATG) and Basiliximab (BSX) as induction therapy in kidney transplant recipients. The purpose of our benchmarking study was to describe the consequences in terms of practices in 6 transplantation centers of a French prospective cohort. Methods We included adult patients who received a first or second kidney graft between 2013 and 2019 (n = 4157). We used logistic regressions to identify characteristics associated with the use of ATG or BSX. Results Use of ATG between the centers ranged from 41% to 75%. We observed different factors associated with the treatment decision. Compared to a first transplant, performing a second graft was the only factor significantly associated with the choice of ATG in all centers. The AUC ranged from 0.67 to 0.91, indicating that the centers seemed to define their own rules. As a result, for patients with the same low immunological risk, the probability of receiving ATG varied from 7% to 36%. We stratified the analyses according to two periods, from 2013 to 2015 and from 2016 to 2019. A similar heterogeneity was observed, and in some cases ATG indications between the centers were inverted.

Domaines: Urologie et Néphrologie

Julie Boucquemont, Yohann Foucher, Christophe Masset, Christophe Legendre, Anne Scemla, et al.. Induction therapy in kidney transplant recipients: Description of the practices according to the calendar period from the French multicentric DIVAT cohort. PLoS ONE, 2020, 15 (10), pp.e0240929. ⟨10.1371/journal.pone.0240929⟩. ⟨hal-04065702⟩