دورية أكاديمية
The Risk of Postkidney Transplant Outcomes by Induction Choice Differs by Recipient Age
| العنوان: | The Risk of Postkidney Transplant Outcomes by Induction Choice Differs by Recipient Age |
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| المؤلفون: | JiYoon B. Ahn, KMD, MPH, Sunjae Bae, KMD, PhD, Nadia M. Chu, PhD, MPH, Lingyu Wang, MBBS, Jongyeon Kim, ScM, Mark Schnitzler, PhD, Gregory P. Hess, MD, MSc, Krista L. Lentine, MD, PhD, Dorry L. Segev, MD, PhD, Mara A. McAdams-DeMarco, PhD |
| المصدر: | Transplantation Direct, Vol 7, Iss 7, p e715 (2021) |
| بيانات النشر: | Wolters Kluwer, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Surgery |
| مصطلحات موضوعية: | Surgery, RD1-811 |
| الوصف: | Background. Among adult kidney transplant (KT) recipients, the risk of post-KT adverse outcomes differs by type of induction immunosuppression. Immune response to induction differs as recipients age; yet, choice of induction is barely tailored by age likely due to a lack of evidence of the risks and benefits. Methods. Using Scientific Registry of Transplant Recipients data, we identified 39336 first-time KT recipients (2010–2016). We estimated the length of stay (LOS), acute rejection (AR), graft failure, and death by induction type using logistic and Cox regression weighted by propensity score to adjust for confounders. We tested whether these estimates differed by age (65+ versus 18–64 y) using a Wald test. Results. Overall, rabbit antithymocyte globulin (rATG) was associated with a decreased risk of AR (odds ratio = 0.79, 95% confidence interval [CI], 0.72-0.85) compared with basiliximab. The effect of induction on LOS and death (interaction P = 0.03 and 0.003) differed by recipient age. Discharge was on average 11% shorter in rATG among younger recipients (relative time = 0.89; 95% confidence interval [CI], 0.81-0.99) but not among older recipients (relative time = 1.01; 95% CI, 0.95-1.08). rATG was not associated with mortality among older (hazard ratio = 1.05; 95% CI, 0.96-1.15), but among younger recipients (hazard ratio = 0.87; 95% CI, 0.80-0.95), it was associated with reduced mortality risk. Conclusions. rATG should be considered to prevent AR, especially among recipients with high-immunologic risk regardless of age; however, choice of induction should be tailored to reduce LOS and risk of mortality, particularly among younger recipients. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2373-8731 00000000 |
| Relation: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001105; https://doaj.org/toc/2373-8731 |
| DOI: | 10.1097/TXD.0000000000001105 |
| URL الوصول: | https://doaj.org/article/ce71f1fe55b248bdaea208767ca63d8f |
| رقم الأكسشن: | edsdoj.71f1fe55b248bdaea208767ca63d8f |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 23738731 00000000 |
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| DOI: | 10.1097/TXD.0000000000001105 |