The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience

Jalalonmuhali, Maisarah and Ng, Kok Peng and Lee, Yee Wan and Gan, Chye Chung and Hing, Albert (Wong) and Wan Md Adnan, Wan Ahmad Hafiz and Cheng, Shian Feng and Chew, Chang Chuan and Ooi, Shok Hoon and Wong, Chew Ming and Lim, Soo Kun (2022) The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience. Transplantation Proceedings, 54 (2). pp. 299-306. ISSN 0041-1345, DOI

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Background. Immunosuppressive therapy is the backbone of kidney transplantation in preventing acute rejection. T-cell depletion after doses of thymoglobulin is dose-dependent, as are their side effects. At the same time, basiliximab and other maintenance immunosuppressive drugs act at different signals on T lymphocytes. Therefore, studying the pattern of lymphocyte subset depletion depending on the induction regime given at transplantation could be an added tool in managing post-transplant recipients.& nbsp;Methodology. This prospective observational study recruited kidney transplant recipients from August 2019 through April 2021 at the University of Malaya Medical Centre. Blood tests for lymphocyte subsets were taken at pre-transplant, 1 week, 1 month, 3 months, and 6 months post-transplantation. At transplantation, recipients received either basiliximab, low-dose thymoglobulin (cumulative dose: 1.5 mg/kg), or standard-dose thymoglobulin (cumulative dose: 5 mg/kg).& nbsp;Results. A total of 39 patients were recruited: 38.5% received basiliximab (15 of 39), 15.4% received low-dose thymoglobulin (6 of 39), and 46.2% received standard-dose thymoglobulin (18 of 39). Absolute lymphocyte counts 1 week post-transplantation were 1.5 +/- 0.84 x 10(9)/L for basiliximab, 0.7 +/-& nbsp;0.57 x 10(9)/L for low-dose thymoglobulin, and 0.1 +/- 0.08 x 10(9)/L for standard-dose thymoglobulin (P < .001). The CD4+ and CD8+ counts were severely depleted in the standard-dose thymoglobulin group, with a statistically significant differenceup to 6 months post-transplantation. In the low-dose thymoglobulin group, the CD4+ and CD8+ counts were depleted at 1 week post-transplantation and recovered at 1 month post-transplantation. There was no difference in allograft function and incidence of allograft rejection across groups.& nbsp;Conclusions. The effects on lymphocyte counts, CD4+ and CD8+, vary depending on the type and dose of induction immunosuppression. This could be a guiding tool in managing immunosuppression post-transplantation depending on the patient's immunologic risk.

Item Type: Article
Funders: Malaysian Society of Nephrology (MSN)
Uncontrolled Keywords: Immunosuppressive therapy; Kidney transplantation; Immunosuppressive drugs; Patient's immunologic risk
Subjects: R Medicine
R Medicine > RD Surgery
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 05 Oct 2023 04:05
Last Modified: 05 Oct 2023 04:05

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