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12 July 2019 : Original article  

Infectious Complications of Induction Therapies in Kidney Transplantation

Adem Bayraktar1ABC, Yunus Catma2BD, Arif Akyildiz2BD, Erol Demir2ABCDEF*, Huseyin Bakkaloglu1AC, Ali Riza Ucar2AC, Ahmet Burak Dirim2BD, Sebahat Usta Akgul3BCD, Sonay Temurhan3BCD, Ali Fuat Kaan Gok1BCD, Yasemin Ozluk4BCDE, Isin Kilicaslan4ACD, Fatma Savran Oguz3BCD, Mehmet Sukru Sever2ADEF, Ali Emin Aydin1ACF, Aydin Turkmen2ACDEF

DOI: 10.12659/AOT.915885

Ann Transplant 2019; 24:412-417


BACKGROUND: Cytomegalovirus (CMV) and BK virus (BKV) are post-transplant opportunistic viral infections that affect patient and graft survival. This study was designed to evaluate the risk of BKV nephropathy and CMV disease in kidney transplant recipients who received induction therapy with ATG or basiliximab.

MATERIAL AND METHODS: We retrospectively analyzed information on 257 adult patients who underwent kidney transplantation between January 2007 and 2017. Patients were categorized into 3 groups according to the induction therapies. The primary endpoint was the onset of CMV disease or biopsy-confirmed BKV nephropathy. The secondary endpoints were biopsy-proven rejection episodes, graft loss, loss to follow-up, and death.

RESULTS: We followed 257 patients for a median of 55.5 months. The incidence of CMV disease was significantly higher in the only ATG group compared to the group without induction treatment (p<0.001). There was no significant difference in the incidence of BKV nephropathy among groups (p>0.05). The dosage of ATG (OR, 10.685; 95% CI, 1.343 5 to 85.009; P=0.025) was independent risk factor for death.

CONCLUSIONS: This study demonstrated that a higher dosage of ATG in high-risk patients is associated with an increased risk of CMV disease and patient death, also, reducing the dosage may be a rational strategy for increasing graft and patient’s survival.

Keywords: BK Virus, Kidney Transplantation, Immunosuppressive Agents, induction chemotherapy, Middle Aged, Polyomavirus Infections, Retrospective Studies, Risk Factors, Tumor Virus Infections, young adult

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358