Impact of Induction Immunosuppression Strategies in Simultaneous Liver/Kidney Transplantation

Background. There is scant data on the use of induction immunosuppression for simultaneous liver/kidney transplantation (SLKT). Methods. We analyzed the Organ Procurement and Transplant Network registry from 1996 to 2016 to compare outcomes of SLKT, based on induction immunosuppression. Results. Of 5172 patients, 941 (18%) received T-cell depletion induction, 1635 (32%) received interleukin 2 receptor antagonist (IL2-RA), and 2596 (50%) received no induction (NI). At 5 years, patient survivals were 68% in the T-cell group, 74% in the IL2-RA group, and 71% in the NI group (P = 0.0006). Five-year liver and kidney allograft survivals were 67% and 64% in the T-cell group, 73% and 70% in the IL2-RA group, and 70% and 68% in the NI group (P = 0.001 and 0.003), respectively. On multivariate analysis, the type of induction had no impact on patient or allograft survival. Maintenance steroids and calcineurin inhibitors (CNIs) at discharge were associated with improved patient and graft survival (steroids: patient survival hazard ratio [HR] 0.37 [0.27–0.52], liver survival HR 0.43 [0.31–0.59], kidney survival HR 0.46 [0.34–0.63]; P
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research