Evaluating anti-thymocyte globulin induction doses for better allograft and patient survival in Asian kidney transplant recipientsopen access
- Authors
- Shim, Ye Eun; Ko, Youngmin; Lee, Jung Pyo; Jeon, Jin Seok; Jun, Heungman; Yang, Jaeseok; Kim, Myoung Soo; Lim, Seong Jun; Kwon, Hye Eun; Jung, Joo Hee; Kwon, Hyunwook; Kim, Young Hoon; Lee, Jungbok; Shin, Sung; Kong, Jin Min; Kwon, Oh Jung; Kim, Deok Gie; Jung, Cheol Woong; Kim, Yeong Hoon; Kim, Joong Kyung; Kim, Chan-Duck; Min, Ji Won; Lee, Sik; Park, Yeon Ho; Park, Jae Berm; Park, Jung Hwan; Park, Jong-Won; Ban, Tae Hyun; Song, Sang Heon; Song, Seung Hwan; Shin, Ho Sik; Yang, Chul Woo; Yoon, Hye Eun; Lee, Kang Wook; Lee, Dong Ryeol; Lee, Dong Won; Oh, Jieun; Lee, Sang-Ho; Lee, Su Hyung; Lee, Yu Ho; Lee, Jeong-Hoon; Jeong, Kyung Hwan; Chung, Ku Yong; Lee, Jong Soo; Ki, Ju Man; Chae, Dong-Wan; Choi, Soo Jin Na; Han, Seungyeup; Huh, Kyu Ha
- Issue Date
- Dec-2023
- Publisher
- Nature Research
- Citation
- Scientific Reports, v.13, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- Scientific Reports
- Volume
- 13
- Number
- 1
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/107579
- DOI
- 10.1038/s41598-023-39353-6
- ISSN
- 2045-2322
- Abstract
- Anti-thymocyte globulin (ATG) is currently the most widely prescribed induction regimen for preventing acute rejection after solid organ transplantation. However, the optimal dose of ATG induction regimen in Asian kidney recipients is unclear. Using the Korean Organ Transplantation Registry, we performed a retrospective cohort study of 4579 adult patients who received renal transplantation in South Korea and divided them into three groups according to the induction regimen: basiliximab group (n = 3655), low-dose ATG group (≤ 4.5 mg/kg; n = 467), and high-dose ATG group (> 4.5 mg/kg; n = 457). We applied the Toolkit for Weighting and Analysis of Nonequivalent Groups (TWANG) package to generate high-quality propensity score weights for intergroup comparisons. During four-year follow-ups, the high-dose ATG group had the highest biopsy-proven acute rejection rate (basiliximab 20.8% vs. low-dose ATG 22.4% vs. high-dose ATG 25.6%; P < 0.001). However, the rates of overall graft failure (4.0% vs. 5.0% vs. 2.6%; P < 0.001) and mortality (1.7% vs. 2.8% vs. 1.0%; P < 0.001) were the lowest in the high-dose ATG group. Our results show that high-dose ATG induction (> 4.5 mg/kg) was superior to basiliximab and low-dose ATG induction in terms of graft and patient survival in Asian patients undergoing kidney transplant. © 2023, The Author(s).
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