AUTHOR=Masset Christophe , Kerleau Clarisse , Blancho Gilles , Hourmant Maryvonne , Walencik Alexandre , Ville Simon , Kervella Delphine , Cantarovich Diego , Houzet Aurélie , Giral Magali , Garandeau Claire , Dantal Jacques , the Nantes DIVAT Consortium , Blancho Gilles , Branchereau Julien , Cantarovich Diego , Cesbron Anne , Chapelet Agnès , Dantal Jacques , Delbos Florent , Deltombe Clément , Devis Anne , Figueres Lucile , Gaisne Raphael , Garandeau Claire , Giral Magali , Gourraud-Vercel Caroline , Hourmant Maryvonne , Kandel-Aznar Christine , Karam Georges , Kerleau Clarisse , Kervella Delphine , Leclech Alice , Leman Claire , Masset Christophe , Meurette Aurélie , Renaudin Karine , Ville Simon , Walencik Alexandre TITLE=Very Low Dose Anti-Thymocyte Globulins Versus Basiliximab in Non-Immunized Kidney Transplant Recipients JOURNAL=Transplant International VOLUME=36 YEAR=2023 URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.10816 DOI=10.3389/ti.2023.10816 ISSN=1432-2277 ABSTRACT=

The choice between Basiliximab (BSX) or Anti-Thymocyte Globulin (ATG) as induction therapy in non-immunized kidney transplant recipients remains uncertain. Whilst ATG may allow steroid withdrawal and a decrease in tacrolimus, it also increases infectious complications. We investigated outcomes in non-immunized patients receiving a very low dosage of ATG versus BSX as induction. Study outcomes were patient/graft survival, cumulative probabilities of biopsy proven acute rejection (BPAR), infectious episode including CMV and post-transplant diabetes (PTD). Cox, logistic or linear statistical models were used depending on the studied outcome and models were weighted on propensity scores. 100 patients received ATG (mean total dose of 2.0 mg/kg) and 83 received BSX. Maintenance therapy was comparable. Patient and graft survival did not differ between groups, nor did infectious complications. There was a trend for a higher occurrence of a first BPAR in the BSX group (HR at 1.92; 95%CI: [0.77; 4.78]; p = 0.15) with a significantly higher BPAR episodes (17% vs 7.3%, p = 0.01). PTD occurrence was significantly higher in the BSX group (HR at 2.44; 95%CI: [1.09; 5.46]; p = 0.03). Induction with a very low dose of ATG in non-immunized recipients was safe and associated with a lower rate of BPAR and PTD without increasing infectious complications.