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The Results after Induction of Rabbit Anti-Thymocyte Globulin (rATG) in the Deceased Donor Kidney Transplantation Using the Expanded Criteria Donor

Introduction There are limited data concerning the benefits and adverse effects associated with different induction regimens in kidney transplant recipients using expanded criteria donor (ECD). The aim of this study is to evaluate the outcome after rATG induction with deceased donor kidney transplantation using the ECD. Materials and Methods Between May 2006 and Aug. 2017, 57 patients underwent DDKT at Department of Surgery at Konyang University Hospital, Daejeon, Korea. We have rATG induction criteria which were donor age > 50 years old or donor Cr level > 1.3mg/dl except to HBV carrier and HCV recipients. Recipients were divided into two groups; the rATG group: n = 35 and the basiliximab group: n = 22. The following characteristics were evaluated retrospectively through the medical records. Results The 5-year patient survival in the rATG group was 94.1% compared to 85.9% in the basiliximab group (p = 0.323). Graft survival at 5-year was 86.8% and 95.5% in the rATG and the basiliximab group (p = 0.925) respectively. Incidence of biopsy proven acute rejection episodes was not significantly different in the basiliximab group (5cases (14.3%) vs. 5cases (22.7%), p = 0.485). Delayed graft function was not significantly different in both groups. (4cases (11.4%) vs. 1case (4.5%), p = 0.639). Creatinine level by period of recipients was more increased in rATG group (6st months: 1.72±1.43mg/dℓ vs. 1.03±0.31mg/dℓ, P = 0.043, 12st months: 1.63±1.33mg/dℓ vs. 1.03±0.27mg/dℓ, P = 0.075). Complications during the follow periods were significantly increased in rATG group groups (91.4% vs. 68.2%, p =0.035). CMV viremia and BK uremia rate was tended to increase in the rATG group groups (40.0% and 34.3%). Conclusion The results show that patient survival and graft survival after induction of rATG of the deceased donor kidney transplantation using the ECD is not different. But an episode of complications in the deceased donor kidney transplantation using the ECD after induction of rATG is more prevalent.