Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation

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• dc.contributor.author Toapanta, Néstor
• dc.contributor.author Jiménez, Sara
• dc.contributor.author Molina-Gómez, María
• dc.contributor.author Maruri-Kareaga, Naroa
• dc.contributor.author Llinàs-Mallol, Laura
• dc.contributor.author Villanego, Florentino
• dc.contributor.author Facundo, Carme
• dc.contributor.author Rodríguez-Ferrero, Marisa
• dc.contributor.author Montero, Núria
• dc.contributor.author Vázquez-Sanchez, Teresa
• dc.contributor.author Gutiérrez-Dalmau, Alex
• dc.contributor.author Beneyto, Maria Isabel
• dc.contributor.author Franco, Antonio
• dc.contributor.author Hernández-Vicente, Ana
• dc.contributor.author Pérez-Tamajon, M. Lourdes
• dc.contributor.author Martín, Paloma
• dc.contributor.author Ramos-Verde, Ana María
• dc.contributor.author Castañeda, Zaira
• dc.contributor.author Bestard, Oriol
• dc.contributor.author Moreso, Francesc
• dc.date.accessioned 2023-03-06T07:19:56Z
• dc.date.available 2023-03-06T07:19:56Z
• dc.date.issued 2022
• dc.description.abstract Coronavirus disease 2019 (COVID-19) in kidney transplant recipients has a high risk of complications and mortality, especially in older recipients diagnosed during the early period after transplantation. Management of immunosuppression has been challenging during the pandemic. We investigated the impact of induction immunosuppression, either basiliximab or thymoglobulin, on the clinical evolution of kidney transplant recipients developing COVID-19 during the early period after transplantation. We included kidney transplant recipients with ˂6 months with a functioning graft diagnosed with COVID-19 from the initial pandemic outbreak (March 2020) until 31 July 2021 from different Spanish centres participating in a nationwide registry. A total of 127 patients from 17 Spanish centres developed COVID-19 during the first 6 months after transplantation; 73 (57.5%) received basiliximab and 54 (42.5%) thymoglobulin. Demographics were not different between groups but patients receiving thymoglobulin were more sensitized [calculated panel reactive antibodies (cPRAs) 32.7 ± 40.8% versus 5.6 ± 18.5%] and were more frequently retransplants (30% versus 4%). Recipients ˃65 years of age treated with thymoglobulin showed the highest rate of acute respiratory distress syndrome [64.7% versus 37.1% for older recipients receiving thymoglobulin and basiliximab (P < .05), respectively, and 23.7% and 18.9% for young recipients receiving basiliximab and thymoglobulin (P > .05)], respectively, and the poorest survival [mortality rate 64.7% and 42.9% for older recipients treated with thymoglobulin and basiliximab, respectively (P < .05) and 8.1% and 10.5% for young recipients treated with thymoglobulin and basiliximab (P > .05), respectively]. Older recipients treated with thymoglobulin showed the poorest survival in the Cox regression model adjusted for comorbidities. Thus thymoglobulin should be used with caution in older recipients during the present pandemic era.
• dc.format.mimetype application/pdf
• dc.identifier.citation Toapanta N, Jiménez S, Molina-Gómez M, Maruri-Kareaga N, Llinàs-Mallol L, Villanego F, et al. Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation. Clin Kidney J. 2022 Apr 30; 15(11): 2039-45. DOI: 10.1093/ckj/sfac112
• dc.identifier.doi http://dx.doi.org/10.1093/ckj/sfac112
• dc.identifier.issn 2048-8505
• dc.identifier.uri http://hdl.handle.net/10230/56037
• dc.language.iso eng
• dc.publisher Oxford University Press
• dc.rights Copyright © Toapanta N, Jiménez S, Molina-Gómez M, Maruri-Kareaga N, Llinàs-Mallol L, Villanego F, et al. 2022. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact moc.puo@snoissimrep.slanruoj
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
• dc.subject.keyword COVID-19 infection
• dc.subject.keyword Basiliximab
• dc.subject.keyword Lymphocyte-depleting agents
• dc.subject.keyword Renal transplantation
• dc.title Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion