Swaab Tim D A, Pol Robert A, Crop Meindert J, Sanders Jan-Stephan F, Berger Stefan P, Hofker Hendrik S, Bakker Stephan J L, Te Velde-Keyzer Charlotte A
Department of Surgery, Division of Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Sci Rep. 2025 Jul 1;15(1):20732. doi: 10.1038/s41598-025-06750-y.
During the COVID-19 pandemic our center adjusted the standard induction therapy for normal immunological risk simultaneous pancreas-kidney (SPK) transplantations from T-cell depletion by alemtuzumab (ALEM) to IL-2 receptor blocking by basiliximab (IL2R). Here, we analyze the impact of this change on 1 year post-transplantation outcomes. Thirty-six adult patients who underwent SPK transplantation between June 2015 and June 2023 were included, of whom 21 before February 2020 (ALEM) and 15 after February 2020 (IL2R). Patients were stratified into two groups based on the induction therapy received. One death occurred during the follow up period. A total of three pancreas and two kidney grafts were lost. No differences between kidney and pancreas graft function or rejection rates were observed. Patients receiving IL2R induction had significantly lower 30 day postoperative complication rates (34 vs. 46%, p = 0.03) and experienced fewer bacterial infections (< 6 months: 47 vs. 81%, p = 0.03). Additionally, lower rates of viral (including CMV) and fungal infections were observed. IL2R patients also had a significantly shorter hospital admission durations (14 vs. 30 days, p < 0.001). In conclusion, IL2R induction in SPK recipients was associated with similar short-term graft function and potentially improved outcomes compared to ALEM, warranting cautious interpretation due to sample size.
在新冠疫情期间，我们中心将正常免疫风险的同期胰肾联合移植（SPK）的标准诱导治疗从使用阿仑单抗（ALEM）进行T细胞清除调整为使用巴利昔单抗（IL2R）阻断IL-2受体。在此，我们分析了这一变化对移植后1年结局的影响。纳入了2015年6月至2023年6月期间接受SPK移植的36例成年患者，其中2020年2月之前的有21例（ALEM组），2020年2月之后的有15例（IL2R组）。根据所接受的诱导治疗将患者分为两组。随访期间有1例死亡。总共丢失了3个胰腺移植物和2个肾脏移植物。未观察到肾脏和胰腺移植物功能或排斥率之间的差异。接受IL2R诱导的患者术后30天并发症发生率显著更低（34%对46%，p = 0.03），且细菌感染更少（<6个月：47%对81%，p = 0.03）。此外，观察到病毒（包括巨细胞病毒）和真菌感染率也更低。IL2R组患者的住院时间也显著更短（14天对30天，p < 0.001）。总之，与ALEM相比，SPK受者使用IL2R诱导与相似的短期移植物功能相关，且可能改善结局，但由于样本量原因需谨慎解读。
