Outcomes of living donor renal transplant recipients with and without basiliximab induction: A long-term follow-up study

ObjectivesTo compare the outcomes of renal allograft recipients with and without basiliximab Induction in living donor renal transplantation.MethodsWe included 296 renal allograft recipients, 148 patients with basiliximab induction and 148 without induction (controls) therapy from 1st Jan 2003 to 31st December 2011 and followed up till end of study period December 2013. The control patients were next renal transplant recipients who were age and gender matched with similar ratio of HLA mismatch. The acute rejection episodes, delayed graft function, patient survival; and the death censored and death non-censored graft survival was compared between the two groups of patients with and without induction therapy.ResultsThe demographic profile and characteristics of the patients were similar in both groups of patients. The proportion of patients with HLA mismatches, and the immunosuppression protocols other than basiliximab induction was also similar in both groups. The number of biopsy proven acute rejection at 6 months was 10 (6.7%) in patients with induction and 22 (14.8%), (p = 0.028) in patients without induction. Delayed graft function was observed in 9 (6%) patients with induction and 14 (9%), (p = 0.39) patients without induction. Graft failure was observed in 5 (3.38% patients with induction and 14 (9.4%), (p = 0.05) patients without induction at end of follow up. The overall cumulative survival of all patients at 1, 2, 5 and 10 years was 95%, 92%, 85% and 80%, respectively. The mean cumulative patient survival with induction was 120 (95% CI 114–126) months; and without induction was 102 (95% CI 94–110) months (p = 0.001). The 1, 2, 5, and 10 years patient survival; death censored and death non censored graft survival was superior in patients with induction compared to the patients without induction therapy on long term follow up.ConclusionAcute rejection was significantly less in patients with induction compared to that of patients without induction. The cumulative short and long term patients and graft survival was significantly better in patients with induction compared to that of patients without induction.