Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation

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 im...

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Autores: Toapanta, N, Jimenez, S, Molina-Gomez, M, Maruri-Kareaga, N, Llinas-Mallol, L, Villanego, F, Facundo, C, Rodriguez-Ferrero, M, Montero, N, Vazquez-Sanchez, T, Gutierrez-Dalmau, A, Beneyto, I, Franco, A, Hernandez-Vicente, A, Perez-Tamajon, ML, Martin, P, Ramos-Verde, AM, Castaneda, Z, Bestard, O, Moreso, F
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Recursos:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p9058
Acesso em linha:https://isabial.portalinvestigacion.com/publicaciones9058
Access Level:acceso abierto
Palavra-chave:basiliximab
COVID-19 infection
lymphocyte-depleting agents
renal transplantation
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repository_id_str
spelling Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantationToapanta, NJimenez, SMolina-Gomez, MMaruri-Kareaga, NLlinas-Mallol, LVillanego, FFacundo, CRodriguez-Ferrero, MMontero, NVazquez-Sanchez, TGutierrez-Dalmau, ABeneyto, IFranco, AHernandez-Vicente, APerez-Tamajon, MLMartin, PRamos-Verde, AMCastaneda, ZBestard, OMoreso, FbasiliximabCOVID-19 infectionlymphocyte-depleting agentsrenal transplantationCoronavirus 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.OXFORD UNIV PRESS2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones9058Clinical Kidney JournalISSN: 20488505ISSNe: 20488513reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p90582026-06-12T10:20:37Z
dc.title.none.fl_str_mv Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
title Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
spellingShingle Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
Toapanta, N
basiliximab
COVID-19 infection
lymphocyte-depleting agents
renal transplantation
title_short Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
title_full Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
title_fullStr Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
title_full_unstemmed Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
title_sort Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation
dc.creator.none.fl_str_mv Toapanta, N
Jimenez, S
Molina-Gomez, M
Maruri-Kareaga, N
Llinas-Mallol, L
Villanego, F
Facundo, C
Rodriguez-Ferrero, M
Montero, N
Vazquez-Sanchez, T
Gutierrez-Dalmau, A
Beneyto, I
Franco, A
Hernandez-Vicente, A
Perez-Tamajon, ML
Martin, P
Ramos-Verde, AM
Castaneda, Z
Bestard, O
Moreso, F
author Toapanta, N
author_facet Toapanta, N
Jimenez, S
Molina-Gomez, M
Maruri-Kareaga, N
Llinas-Mallol, L
Villanego, F
Facundo, C
Rodriguez-Ferrero, M
Montero, N
Vazquez-Sanchez, T
Gutierrez-Dalmau, A
Beneyto, I
Franco, A
Hernandez-Vicente, A
Perez-Tamajon, ML
Martin, P
Ramos-Verde, AM
Castaneda, Z
Bestard, O
Moreso, F
author_role author
author2 Jimenez, S
Molina-Gomez, M
Maruri-Kareaga, N
Llinas-Mallol, L
Villanego, F
Facundo, C
Rodriguez-Ferrero, M
Montero, N
Vazquez-Sanchez, T
Gutierrez-Dalmau, A
Beneyto, I
Franco, A
Hernandez-Vicente, A
Perez-Tamajon, ML
Martin, P
Ramos-Verde, AM
Castaneda, Z
Bestard, O
Moreso, F
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv basiliximab
COVID-19 infection
lymphocyte-depleting agents
renal transplantation
topic basiliximab
COVID-19 infection
lymphocyte-depleting agents
renal transplantation
description 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.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones9058
url https://isabial.portalinvestigacion.com/publicaciones9058
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv OXFORD UNIV PRESS
publisher.none.fl_str_mv OXFORD UNIV PRESS
dc.source.none.fl_str_mv Clinical Kidney Journal
ISSN: 20488505
ISSNe: 20488513
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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