Outcomes of thymoglobulin versus basiliximab induction therapies in living donor kidney transplant recipients with mild to moderate immunological risk – a retrospective analysis of UNOS database

Figures & data

Figure 1. Details of patient selection from the OPTN database.

Table 1. Baseline characteristics of study groups.

	Thymoglobulin group (1727)	Basiliximab group (788)	p Value
Recipient age in years: mean (standard deviation)	49.51 (13.36)	55.14 (14.21)	<.01
Recipient body mass index (BMI): mean (standard deviation)	28.52 (5.48)	28.43 (5.32)	.72
Recipient sex: male (n,%)	1087 (62.94%)	549 (69.67%)	<.01
Recipient diabetes:	467 (27.04%)	260 (32.99%)	<.01
Yes (n, %)
Ethnicity (n,%):			<.01
White	1107 (64.09%)	535 (67.89%)
Black	273 (15.80%)	76 (9.64%)
Hispanic	203 (11.75%)	101 (12.81%)
Asian	112 (6.48%)	61 (7.74%)
American Indian	9 (0.52%)	5 (0.63%)
Pacific Islander	2 (0.11%)	3 (0.38%)
Multiracial	21 (1.21%)	7 (0.88%)
PRA, % : mean (standard deviation)	10.22 (21.67)	5.09 (14.97)	<.01
Cold ischaemia time in hours: mean (standard deviation)	2.61 (4.17)	2.81 (4.76)	.29
HLA-A mismatch (N,%):			.60
0	135 (7.81%)	54 (6.85%)
1	752 (43.54%)	338 (42.89%)
2	840 (48.63%)	396 (50.25%)
HLA-B mismatch : (N,%)			.22
0	29 (1.67%)	12 (1.52%)
1	401 (23.21%)	208 (26.39%)
2	1297 (75.10%)	568 (72.08%)
Glucocorticoid maintenance regimen (n,%):	1127 (65.33%)	671 (85.15%)	<.01
Donor age: mean (standard deviation)	44.73 (12.15)	47.82 (12.83)	<.01
Donor type:
Unrelated (n,%)	1510 (87.43%)	685 (86.92%)	.72
Donor sex: male (n,%)	590 (34.16%)	259 (32.86%)	.52
Days of induction therapies	1 day:36 2 days: 155 3 days: 918 4 days 484 5 days 98 6 days: 3 7 days 2 8 days : 3	2 days: 788

Table 2. Instrumental variable-ordered probit regression analysis assessing the relationship between induction therapy and acute rejection episodes at 12 months post-transplant.

	Coefficient	Standard error	p Value	95% Confidence interval
Induction therapy (basiliximab versus thymoglobulin)	−0.229	0.142	.106	−0.508 to −0.049
Sex
Male	0.019	0.093	.983	−0.181 to 0.185
Body mass index	0.006	0.007	.375	−0.008 to 0.022
Cold ischaemia time	0.002	0.010	.777	−0.016 to 0.022
Serum creatinine at discharge	0.070	0.029	.016	0.013 to 0.127
Calculated PRA	− <0.001	0.002	.866	−0.004 to 0.003
Ethnicity
Black	0.017	0.120	.887	−0.219 to 0.253
Hispanic	−0.166	0.138	.229	−0.438 to 0.104
Asian	−0.554	0.230	.016	−1.006 to −0.102
American Indian	0.053	0.536	.920	−0.998 to 1.105
Pacific Islander	−4.814	3005.509	.999	−5895.504 to 5885.875
Multiracial	−4.556	1293.668	.997	−2540.099 to 2530.987
Recipient age	−0.014	0.003	<.001	−0.021 to −0.006
HLA-A mismatch	0.061	0.710	.390	−0.078 to 0.200
HLA-B mismatch	−0.092	0.086	.285	−0.549 to −0.187
Glucocorticoid maintenance	−0.368	0.0924	<.001	−0.549 to −0.187
Donor age	0.014	0.004	.001	−0.005 to 0.224

Table 3. Instrumental variables linear regression model assessing the relationship between serum creatinine at one-year post-transplant and induction therapy.

	Coefficient	Robust standard error	p Value	95% Confidence interval
Induction therapy (basiliximab versus thymoglobulin)	−0.024	0.015	.126	−0.054 to 0.006
Sex
Male	0.238	0.013	<.001	0.211 to 0.265
Body mass index	0.002	0.001	.019	<0.001 to 0.005
Cold ischaemia time	−0.004	0.001	<.001	−0.006 to −0.001
Serum creatinine at discharge	0.089	0.010	<.001	0.068 to 0.109
Calculated PRA %	<0.001	<0.001	.220	− <0.001 to 0.001
Ethnicity
Black	0.111	0.021	<.001	0.070 to 0.153
Hispanic	−0.049	0.018	.009	−0.086 to −0.012
Asian	−0.136	0.023	<.001	−0.182 to −0.089
American Indian	−0.017	0.061	.783	−0.138 to 0.104
Pacific Islander	0.008	0.082	.917	−0.153 to 0.170
Multiracial	0.008	0.047	.861	−0.084 to 0.101
Recipient age	−0.004	<0.001	<.001	−0.005 to −0.003
HLA-A mismatch	0.008	0.010	.410	−0.011 to 0.028
HLA-B mismatch	−0.004	0.012	.741	−0.028 to 0.020
Glucocorticoid maintenance	−0.041	0.014	.005	−0.070 to −0.012
Donor age	0.007	<0.001	<.001	.006 to 0.008

Data availability statement

Data is available in the Organ Procurement and Transplantation Network (OPTN) database. Data can be accessed through: https://optn.transplant.hrsa.gov. Code availability: STATA Package 17 was used for statistical analysis.