Interleukin-2 receptor antibody reduces rejection rates and graft loss in live-donor kidney transplant recipients

Wai H. Lim, Sean H. Chang, Steve J. Chadban, Scott B. Campbell, Hannah Dent, Graeme R. Russ, Stephen McDonald

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: The use of interleukin-2 receptor antibody (IL-2Ra) induction has been associated with reduced rejection rates in both live and deceased donor kidney transplantation. However, the longer term effect of IL-2Ra induction on estimated glomerular filtration rates and graft and patient survival remains unclear. METHODS: Using Australia and New Zealand Dialysis and Transplant Registry, live donor renal transplant recipients in Australia between 2001 and 2005 were studied (n=1106). Multiple organ graft recipients and those receiving T-cell depletive induction therapy or steroid-or calcineurin-free inhibitor regimens were excluded. Outcomes analyzed included the presence of rejection at 6 months, estimated glomerular filtration rate at 1 and 3 years, 5 years graft and patient survival. RESULTS: A total of 41.7% of live donor renal transplant recipients received IL-2Ra induction. Recipients of IL-2Ra experienced a 51% reduction in the incidence of acute rejection (odds ratio 0.49, 95%CI 0.36-0.67; P<0.001). In addition, the use of IL-2Ra was associated with reduced overall graft loss (hazard ratio 0.58, 95%CI 0.35-0.96; P=0.03) and higher mean estimated glomerular filtration rate at 1 year but not 3 years. There was no association between IL-2Ra induction and death-censored graft loss or death with functioning graft. CONCLUSION: This registry analysis demonstrates that IL-2Ra induction in live donor kidney transplantation is associated with substantial clinical benefits of reduced risk of acute rejection, improved short-term graft function, and reduced graft loss.

Original languageEnglish
Pages (from-to)1208-1213
Number of pages6
JournalTransplantation
Volume88
Issue number10
DOIs
Publication statusPublished - 1 Nov 2009
Externally publishedYes

Keywords

  • ANZDATA registry.
  • Graft survival
  • IL-2 receptor antibody
  • Live donor kidney transplant
  • Rejection

ASJC Scopus subject areas

  • Transplantation

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