Presensitized renal allograft recipients require special management to improve their outcome, and there is no consensus on the optimal immunosuppressive strategy. We retrospectively analyzed clinical data of 82 patients, who were PRA positive pre-transplant (above 10%) and received single bolus ATG and
basiliximab as induction
therapy, and assessed safety and efficacy of two kinds of induction
therapies. Patients of ATG group (n=40) received single bolus ATG (Fresenius, 9 mg/kg preoperatively) and those of
basiliximab group (n=42) were given two doses of
basiliximab (
Simulect, Novartis, 20 mg) on days 0 and 4 post-transplant. All patients received standard triple immunosuppressive therapy with
tacrolimus (FK-506),
mycophenolate mofetil (MMF), and
steroids. The follow-up time was 12 months. There was no hyperacute rejection in two groups, and
delayed graft function occurred in two patients of ATG group and three of
basiliximab group. After 12-month follow-up, more acute rejection (AR) episodes were observed in
basiliximab group than ATG group (35.7% vs. 15%, P=0.032). Although highly significant differences were observed between ATG group and
basiliximab group with respect to the incidence of
thrombocytopenia (P=0.001), single bolus ATG was well tolerated. Incidences of other adverse events and
infection episodes did not differ between two groups (P>0.05). One-year patient and graft survival was 95%, 92.5% and 95.2%, 88.1% in ATG and
basiliximab group respectively (P>0.05). Both single bolus ATG and
basiliximab induction
therapy achieved similar one-year graft/patient survival. However, single bolus ATG yielded much lower AR rate than
basiliximab without increase in
infection episodes and severe adverse events.