The use of lymphocyte-depleting antibodies in specific populations of kidney transplant recipients: A systematic review and meta-analysis

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• dc.contributor.author Montero, Núria
• dc.contributor.author Rodrigo Calabia, Emilio
• dc.contributor.author Crespo Barrio, Marta
• dc.contributor.author Cruzado, Josep Ma.
• dc.contributor.author Gutiérrez-Dalmau, Alex
• dc.contributor.author Mazuecos, Auxiliadora
• dc.contributor.author Sancho, Asunción
• dc.contributor.author Belmar, Lara
• dc.contributor.author Calatayud, Emma
• dc.contributor.author Mora, Paula
• dc.contributor.author Oliveras, Laia
• dc.contributor.author Solà Porta, Eulàlia
• dc.contributor.author Villanego, Florentino
• dc.contributor.author Pascual Santos, Julio
• dc.date.accessioned 2024-06-04T06:20:28Z
• dc.date.available 2024-06-04T06:20:28Z
• dc.date.issued 2023
• dc.description.abstract Background: Recommendations of the use of antibody induction treatments in kidney transplant recipients (KTR) are based on moderate quality and historical studies. This systematic review aims to reevaluate, based on actual studies, the effects of different antibody preparations when used in specific KTR subgroups. Methods: We searched MEDLINE and CENTRAL and selected randomized controlled trials (RCT) and observational studies looking at different antibody preparations used as induction in KTR. Comparisons were categorized into different KTR subgroups: standard, high risk of rejection, high risk of delayed graft function (DGF), living donor, and elderly KTR. Two authors independently assessed the risk of bias. Results: Thirty-seven RCT and 99 observational studies were finally included. Compared to anti-interleukin-2-receptor antibodies (IL2RA), anti-thymocyte globulin (ATG) reduced the risk of acute rejection at two years in standard KTR (RR 0.74, 95%CI 0.61-0.89) and high risk of rejection KTR (RR 0.55, 95%CI 0.43-0.72), but without decreasing the risk of graft loss. We did not find significant differences comparing ATG vs. alemtuzumab or different ATG dosages in any KTR group. Conclusions: Despite many studies carried out on induction treatment in KTR, their heterogeneity and short follow-up preclude definitive conclusions to determine the optimal induction therapy. Compared with IL2RA, ATG reduced rejection in standard-risk, highly sensitized, and living donor graft recipients, but not in high DGF risk or elderly recipients. More studies are needed to demonstrate beneficial effects in other KTR subgroups and overall patient and graft survival.
• dc.format.mimetype application/pdf
• dc.identifier.citation Montero N, Rodrigo E, Crespo M, Cruzado JM, Gutierrez-Dalmau A, Mazuecos A, et al. The use of lymphocyte-depleting antibodies in specific populations of kidney transplant recipients: A systematic review and meta-analysis. Transplant Rev (Orlando). 2023 Dec;37(4):100795. DOI: 10.1016/j.trre.2023.100795
• dc.identifier.doi http://dx.doi.org/10.1016/j.trre.2023.100795
• dc.identifier.issn 0955-470X
• dc.identifier.uri http://hdl.handle.net/10230/60333
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Transplant Rev (Orlando). 2023 Dec;37(4):100795
• dc.rights © 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Immunosuppressive agents
• dc.subject.keyword Kidney transplantation
• dc.subject.keyword Thymoglobulin
• dc.subject.keyword Meta-analysis
• dc.title The use of lymphocyte-depleting antibodies in specific populations of kidney transplant recipients: A systematic review and meta-analysis
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion