Transplante renal: Eficacia y seguridad de la inducción inmunosupresora
In kidney transplantation the initial immunosuppressive regimen, known as induction therapy, influences renal function in different periods as it has impact on acute rejection and delayed graft function, which affect graft survival. However, the use of these agents increases the risk of infections a...
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2015
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| Accés en línia: | http://hdl.handle.net/10872/8054 |
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| Sumari: | In kidney transplantation the initial immunosuppressive regimen, known as induction therapy, influences renal function in different periods as it has impact on acute rejection and delayed graft function, which affect graft survival. However, the use of these agents increases the risk of infections and malignancies. Objectives: It has be compared the effectiveness and safety of induction therapy in renal transplant patients. Methods: We performed a retrospective comparative study of 86 renal transplant patients who were transplanted at the HUC, perios 2009 - 2011, and were followed until June 2012, wich received induction with ATGAM (37), thymoglobulin (14) or basiliximab (35). Results: Acute rejection occurred in 13.5 % of the patients treated with ATGAM, 20 % with basiliximab, 37.5 % with thymoglobulin. Delayed graft function was observed in 54.1% of patients treated with ATGAM, 45.7% in basiliximab and 57.1% in those receiving thymoglobulin.. Graft survival was 88.9 % in ATGAM, 84.7 % and 78.6 % in basiliximab and thymoglobulin, respectively. Receptor survival was 92.9 % in thymoglobulin, 88.7 % in ATGAM and 85.7 % in basiliximab. Limphopenia´s mean in thymoglobulin was 200 cells x mm³, and 800 cells x mm³ in ATGAM and Basiliximab. There was no report of lymphoproliferative disease in the patients. In conclusion: 1. ATGAM was the most effective therapy for prevention of acute rejection. 2. There was no difference between treatment options in preventing delayed graft function. 3. Lymphopenia was more frequently observed in patients treated with thymoglobulin, whereas infections tend to be more frequent in patients with ATGAM, 4. There was no difference in survival of the graft or the patient between groups. |
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