Institute of Medical Sciences, Faculty of Medicine, University of Liverpool, Liverpool, United Kingdom.
Department of Transplantation, Liverpool University Teaching Hospitals NHS Foundation Trust, Liverpool, United Kingdom.
Am J Nephrol. 2020;51(5):366-372. doi: 10.1159/000506970. Epub 2020 Apr 8.
This study aims to assess outcomes of interleukin-2 (IL-2) receptor blocker induction therapy on allograft and patients' outcomes in standard risk recipients in the tacrolimus era, analysing data form the British Renal Transplant Registry.
The study population involved all standard-risk renal transplant patients from 2000 till 2015 who were registered in the UK transplant registry and followed up till May 2018. Standard risk transplants were defined as patients with <2DR mismatch, calculated reaction frequency <20%, live donors or donors after brain death and patients with no previous renal transplantation transplant. We used inverse probability weights to adjust different covariates between the groups. Cox regression analysis for adjusted data and treatment effects model were used to assess outcomes.
In all, 3,597 renal transplant patients were included in the study. Two groups were identified; induction group (n = 2,858) which included patients who received IL-2 receptor blocker induction therapy and the no-induction group (n = 739). There was no significant difference between both groups in terms of estimated glomerular filtration rate (eGFR) rate at 1-year post-transplant (correlation co-efficient = 1.224, 95% CI ranges from -0.347 to 2.796). Average eGFR was 59.922 mL/min/1.73 m2 in the induction group (SD 29.171) and 64.557 mL/min/1.73 m2 in the no-induction groups (SD 46.763). There was no significant difference between both groups regarding graft survival at 5 years post-transplant (hazard ratio [HR] 0.944, 95% CI ranges from 0.599 to 1.485, p = 0.804), patient survival at 5 years post-transplant (HR 0.809, 95% CI ranges from 0.477 to1.372, p = 0.433).
In the standard risk renal transplant population, the IL2 receptor blocker induction regimen does not affect eGFR at 1 year or renal and graft outcomes at 5 years.
本研究旨在评估白细胞介素-2（IL-2）受体阻滞剂诱导治疗在他克莫司时代标准风险受者中的同种异体移植物和患者结局的效果，分析来自英国肾脏移植登记处的数据。
研究人群包括 2000 年至 2015 年间在英国移植登记处登记并随访至 2018 年 5 月的所有标准风险肾移植患者。标准风险移植定义为患者<2DR 错配、计算反应频率<20%、活体供者或脑死亡后供者以及无先前肾移植移植的患者。我们使用逆概率权重来调整组间的不同协变量。使用调整后数据的 Cox 回归分析和治疗效果模型来评估结果。
共纳入 3597 例肾移植患者。确定了两组；诱导组（n = 2858），包括接受 IL-2 受体阻滞剂诱导治疗的患者，以及未诱导组（n = 739）。两组在移植后 1 年时的估算肾小球滤过率（eGFR）率方面没有显著差异（相关系数= 1.224，95%CI 范围从-0.347 到 2.796）。诱导组的平均 eGFR 为 59.922 mL/min/1.73 m2（SD 29.171），未诱导组为 64.557 mL/min/1.73 m2（SD 46.763）。两组在移植后 5 年时的移植物存活率（风险比[HR]0.944，95%CI 范围从 0.599 到 1.485，p = 0.804）和患者存活率（HR 0.809，95%CI 范围从 0.477 到 1.372，p = 0.433）方面均无显著差异。
在标准风险肾移植人群中，IL-2 受体阻滞剂诱导方案不会影响 1 年时的 eGFR 或 5 年时的肾脏和移植物结局。
