Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
Toapanta, Néstor (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Jiménez, S. (Hospital Universitario Ramón y Cajal)
Molina-Gómez, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Maruri-Kareaga, Naroa (Hospital Universitario de Cruces)
Llinàs Mallol, Laura (Hospital del Mar (Barcelona, Catalunya))
Villanego, F. (Hospital Universitario Puerta Del Mar)
Facundo, Carme (Institut d'Investigació Biomèdica Sant Pau)
Rodríguez-Ferrero, M. (Hospital General Universitario Gregorio Marañón)
Montero, Nuria (Hospital Universitari de Bellvitge)
Vázquez-Sanchez, T. (Hospital Universitario Regional de Malaga)
Gutiérrez-Dalmau, A. (Hospital Universitario Miguel Servet (Saragossa))
Beneyto, I. (Hospital Universitari i Politècnic La Fe (València))
Franco, A. (Hospital General Universitario de Alicante)
Hernández-Vicente, A. (Hospital Universitario 12 de Octubre)
Pérez-Tamajon, M.L. (Hospital Universitario de Canarias)
Martin, P. (Clínica Universidad de Navarra)
Ramos-Verde, A.M. (Fundación Jimenez Diaz)
Castañeda, Zaira (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Bestard, Oriol (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Moreso, Francesc (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Coronavirus disease 2019 (COVID-19) in kidney transplant recipients has a high risk of complications and mortality, especially in older recipients diagnosed during the early period after transplantation. Management of immunosuppression has been challenging during the pandemic. We investigated the impact of induction immunosuppression, either basiliximab or thymoglobulin, on the clinical evolution of kidney transplant recipients developing COVID-19 during the early period after transplantation. We included kidney transplant recipients with <6 months with a functioning graft diagnosed with COVID-19 from the initial pandemic outbreak (March 2020) until 31 July 2021 from different Spanish centres participating in a nationwide registry. A total of 127 patients from 17 Spanish centres developed COVID-19 during the first 6 months after transplantation; 73 (57. 5%) received basiliximab and 54 (42. 5%) thymoglobulin. Demographics were not different between groups but patients receiving thymoglobulin were more sensitized [calculated panel reactive antibodies (cPRAs) 32. 7 ± 40. 8% versus 5. 6 ± 18. 5%] and were more frequently retransplants (30% versus 4%). Recipients >65 years of age treated with thymoglobulin showed the highest rate of acute respiratory distress syndrome [64. 7% versus 37. 1% for older recipients receiving thymoglobulin and basiliximab (P <. 05), respectively, and 23. 7% and 18. 9% for young recipients receiving basiliximab and thymoglobulin (P >. 05)], respectively, and the poorest survival [mortality rate 64. 7% and 42. 9% for older recipients treated with thymoglobulin and basiliximab, respectively (P <. 05) and 8. 1% and 10. 5% for young recipients treated with thymoglobulin and basiliximab (P >. 05), respectively]. Older recipients treated with thymoglobulin showed the poorest survival in the Cox regression model adjusted for comorbidities. Thus thymoglobulin should be used with caution in older recipients during the present pandemic era.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 infection ; Basiliximab ; Lymphocyte-depleting agents ; Renal transplantation
Publicat a:	Clinical Kidney Journal, Vol. 15 Núm. 11 (january 2022) , p. 2039-2045, ISSN 2048-8513

DOI: 10.1093/ckj/sfac112
PMID: 36320365

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
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