{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:40:28Z","timestamp":1790800828849,"version":"4.1.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T00:00:00Z","timestamp":1551312000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T00:00:00Z","timestamp":1551312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>\n                    The number of simultaneous liver\u2010kidney transplantations (SLKTs) and use of induction therapy for SLKT have increased recently, without much published evidence, especially in the context of maintenance immunosuppression containing tacrolimus (TAC) and mycophenolic acid (MPA). We queried the Organ Procurement and Transplant Network registry for SLKT recipients maintained on TAC\/MPA at discharge in the United States for 2002\u20132016. The cohort was divided into 3 groups on the basis of induction type: rabbit antithymocyte globulin (r\u2010ATG; n = 831), interleukin 2 receptor antagonist (IL2RA; n = 1558), and no induction (n = 2333). Primary outcomes were posttransplant all\u2010cause mortality and acute rejection rates in kidney and liver allografts at 12 months. Survival rates were analyzed by the Kaplan\u2010Meier method. A propensity score analysis was used to control potential selection bias. Multivariate inverse probability weighted Cox proportional hazard and logistic regression models were used to estimate the hazard ratios (HRs) and odds ratios. Among SLKT recipients, survival estimates at 3 years were lower for recipients receiving r\u2010ATG (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.05). Compared with no induction, the multivariate analyses showed an increased mortality risk with r\u2010ATG (HR, 1.29; 95% confidence interval [CI], 1.10\u20101.52;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.002) and no difference in acute liver or kidney rejection rates at 12 months across all induction categories. No difference in outcomes was noted with IL2RA induction over the no induction category. In conclusion, there appears to be no survival benefit nor reduction in rejection rates for SLKT recipients who receive induction therapy, and r\u2010ATG appears to increase mortality risk compared with no induction.\n                  <\/jats:p>","DOI":"10.1002\/lt.25390","type":"journal-article","created":{"date-parts":[[2018,12,2]],"date-time":"2018-12-02T09:27:58Z","timestamp":1543742878000},"page":"411-424","source":"Crossref","is-referenced-by-count":22,"title":["Lack of Benefit and Potential Harm of Induction Therapy in Simultaneous Liver\u2010Kidney Transplants"],"prefix":"10.1097","volume":"25","author":[{"given":"Nashila","family":"AbdulRahim","sequence":"first","affiliation":[{"name":"Divisions of Nephrology,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Anderson","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman","family":"Kotla","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatesh K.","family":"Ariyamuthu","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mythili","family":"Ghanta","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"MacConmara","sequence":"additional","affiliation":[{"name":"Department of Surgery,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannan R.","family":"Tujios","sequence":"additional","affiliation":[{"name":"Digestive and Liver Diseases,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjmand","family":"Mufti","sequence":"additional","affiliation":[{"name":"Digestive and Liver Diseases,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Division of Nephrology,Columbia University Medical Center,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge A.","family":"Marrero","sequence":"additional","affiliation":[{"name":"Digestive and Liver Diseases,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parsia A.","family":"Vagefi","sequence":"additional","affiliation":[{"name":"Department of Surgery,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bekir","family":"Tanriover","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,2,28]]},"reference":[{"key":"lt25390-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"2901","DOI":"10.1111\/j.1600-6143.2012.04190.x","article-title":"Simultaneous liver\u2010kidney transplantation summit: current state and future directions","volume":"12","year":"2012","journal-title":"Am J Transplant"},{"key":"lt25390-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"4567","DOI":"10.1016\/j.transproceed.2010.09.169","article-title":"Interleukin\u20102 receptor antagonists in liver transplantation: a meta\u2010analysis of randomized trials","volume":"42","year":"2010","journal-title":"Transplant Proc"},{"issue":"suppl 1","key":"lt25390-bib-0003-20240115","first-page":"174","article-title":"OPTN\/SRTR 2015 annual data report: liver","volume":"17","year":"2017","journal-title":"Am J Transplant"},{"key":"lt25390-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.2215\/CJN.13171215","article-title":"Acute rejection rates and graft outcomes according to induction regimen among recipients of kidneys from deceased donors treated with tacrolimus and mycophenolate","volume":"11","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"key":"lt25390-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1097\/TP.0000000000001310","article-title":"Cost\u2010effectiveness of antibody\u2010based induction therapy in deceased donor kidney transplantation in the United States","volume":"101","year":"2017","journal-title":"Transplantation"},{"key":"lt25390-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.2215\/CJN.08710814","article-title":"Induction therapies in live donor kidney transplantation on tacrolimus and mycophenolate with or without steroid maintenance","volume":"10","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"key":"lt25390-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B","article-title":"Propensity score methods for bias reduction in the comparison of a treatment to a non\u2010randomized control group","volume":"17","year":"1998","journal-title":"Stat Med"},{"key":"lt25390-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1093\/aje\/kwj047","article-title":"Results of multivariable logistic regression, propensity matching, propensity adjustment, and propensity\u2010based weighting under conditions of nonuniform effect","volume":"163","year":"2006","journal-title":"Am J Epidemiol"},{"key":"lt25390-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/MLR.0b013e3181c1328f","article-title":"The multiple propensity score as control for bias in the comparison of more than two treatment arms: an introduction from a case study in mental health","volume":"48","year":"2010","journal-title":"Med Care"},{"key":"lt25390-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1111\/tri.12100","article-title":"Induction immunosuppression in liver transplantation: a review","volume":"26","year":"2013","journal-title":"Transpl Int"},{"key":"lt25390-bib-0011-20240115","first-page":"119","article-title":"Outcomes in simultaneous liver kidney transplants in the setting of a positive crossmatch: a single center experience","volume":"32","year":"2016","journal-title":"Clin Transpl"},{"key":"lt25390-bib-0012-20240115","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1097\/TP.0b013e3182a688c0","article-title":"Crossmatch\u2010positive liver transplantation in patients receiving thymoglobulin\u2010rituximab induction","volume":"97","year":"2014","journal-title":"Transplantation"},{"key":"lt25390-bib-0013-20240115","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1111\/ctr.12808","article-title":"Functional status predicts postoperative mortality after liver transplantation","volume":"30","year":"2016","journal-title":"Clin Transplant"},{"key":"lt25390-bib-0014-20240115","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1002\/lt.24189","article-title":"Propensity score\u2010based survival benefit of simultaneous liver\u2010kidney transplant over liver transplant alone for recipients with pretransplant renal dysfunction","volume":"22","year":"2016","journal-title":"Liver Transpl"},{"key":"lt25390-bib-0015-20240115","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.ekir.2016.07.008","article-title":"Simultaneous liver kidney transplantation in liver transplant candidates with renal dysfunction: importance of creatinine levels, dialysis, and organ quality in survival","volume":"1","year":"2016","journal-title":"Kidney Int Rep"},{"key":"lt25390-bib-0016-20240115","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1111\/j.1600-6143.2004.00462.x","article-title":"Association of center volume with outcome after liver and kidney transplantation","volume":"4","year":"2004","journal-title":"Am J Transplant"},{"key":"lt25390-bib-0017-20240115","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/j.1477-2574.2012.00503.x","article-title":"Centre volume and resource consumption in liver transplantation","volume":"14","year":"2012","journal-title":"HPB (Oxford)"},{"key":"lt25390-bib-0018-20240115","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1097\/TP.0b013e3182590d6b","article-title":"Combined liver\u2010kidney transplantation is preferable to liver transplant alone for cirrhotic patients with renal failure","volume":"94","year":"2012","journal-title":"Transplantation"},{"key":"lt25390-bib-0019-20240115","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/MOT.0b013e328338f638","article-title":"Combined liver and kidney transplantation","volume":"15","year":"2010","journal-title":"Curr Opin Organ Transplant"},{"issue":"suppl 1","key":"lt25390-bib-0020-20240115","first-page":"172","article-title":"OPTN\/SRTR 2016 annual data report: liver","volume":"18","year":"2018","journal-title":"Am J Transplant"},{"key":"lt25390-bib-0021-20240115","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1001\/archsurg.141.8.735","article-title":"Long\u2010term analysis of combined liver and kidney transplantation at a single center","volume":"141","year":"2006","journal-title":"Arch Surg"},{"key":"lt25390-bib-0022-20240115","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1097\/01.TP.0000071204.03720.BB","article-title":"Analysis of the United Network for Organ Sharing database comparing renal allografts and patient survival in combined liver\u2010kidney transplantation with the contralateral allografts in kidney alone or kidney\u2010pancreas transplantation","volume":"76","year":"2003","journal-title":"Transplantation"},{"key":"lt25390-bib-0023-20240115","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1056\/NEJMc0805714","article-title":"Long\u2010term results of rabbit antithymocyte globulin and basiliximab induction","volume":"359","year":"2008","journal-title":"N Engl J Med"},{"key":"lt25390-bib-0024-20240115","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1097\/00007890-200109270-00012","article-title":"Induction versus noninduction in renal transplant recipients with tacrolimus\u2010based immunosuppression","volume":"72","year":"2001","journal-title":"Transplantation"},{"key":"lt25390-bib-0025-20240115","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1053\/j.gastro.2010.10.059","article-title":"Immunologic basis of graft rejection and tolerance following transplantation of liver or other solid organs","volume":"140","year":"2011","journal-title":"Gastroenterology"},{"key":"lt25390-bib-0026-20240115","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/liv.12917","article-title":"Peripheral phenotype and gene expression profiles of combined liver\u2010kidney transplant patients","volume":"36","year":"2016","journal-title":"Liver Int"},{"issue":"suppl 1","key":"lt25390-bib-0027-20240115","first-page":"21","article-title":"OPTN\/SRTR 2015 annual data report: kidney","volume":"17","year":"2017","journal-title":"Am J Transplant"},{"issue":"suppl 3","key":"lt25390-bib-0028-20240115","first-page":"S1","article-title":"KDIGO clinical practice guideline for the care of kidney transplant recipients","volume":"9","year":"2009","journal-title":"Am J Transplant"},{"key":"lt25390-bib-0029-20240115","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/01.TP.0000109643.32659.C4","article-title":"Interleukin 2 receptor antagonists for renal transplant recipients: a meta\u2010analysis of randomized trials","volume":"77","year":"2004","journal-title":"Transplantation"},{"key":"lt25390-bib-0031-20240115","first-page":"CD010253","article-title":"Gluud C. Antibody induction versus placebo, no induction, or another type of antibody induction for liver transplant recipients","volume":"6","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"lt25390-bib-0032-20240115","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1053\/jlts.2002.30302","article-title":"Improved treatment response with basiliximab immunoprophylaxis after liver transplantation: results from a double\u2010blind randomized placebo\u2010controlled trial","volume":"8","year":"2002","journal-title":"Liver Transpl"},{"key":"lt25390-bib-0033-20240115","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.jss.2006.08.025","article-title":"Anti\u2010IL2 induction in liver transplantation with 93% rejection\u2010free patient and graft survival at 18 months","volume":"138","year":"2007","journal-title":"J Surg Res"},{"key":"lt25390-bib-0034-20240115","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1053\/jlts.2002.30882","article-title":"Immunoprophylaxis with basiliximab, a chimeric anti\u2010interleukin\u20102 receptor monoclonal antibody, in combination with azathioprine\u2010containing triple therapy in liver transplant recipients","volume":"8","year":"2002","journal-title":"Liver Transpl"},{"key":"lt25390-bib-0035-20240115","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1097\/01.TP.0000134970.92694.68","article-title":"Efficacy and safety of basiliximab with a tacrolimus\u2010based regimen in liver transplant recipients","volume":"78","year":"2004","journal-title":"Transplantation"},{"key":"lt25390-bib-0036-20240115","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1080\/07853890.2016.1257862","article-title":"Anti\u2010interleukin\u20102 receptor antibodies for the prevention of rejection in liver transplant recipients: a systematic review and meta\u2010analysis","volume":"49","year":"2017","journal-title":"Ann Med"},{"key":"lt25390-bib-0037-20240115","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1002\/lt.21905","article-title":"Thymoglobulin induction in liver transplant recipients with a tacrolimus, mycophenolate mofetil, and steroid immunosuppressive regimen: a five\u2010year randomized prospective study","volume":"15","year":"2009","journal-title":"Liver Transpl"},{"key":"lt25390-bib-0038-20240115","doi-asserted-by":"crossref","first-page":"211","DOI":"10.2146\/ajhp090636","article-title":"Induction immunosuppressive therapies in renal transplantation","volume":"68","year":"2011","journal-title":"Am J Health Syst Pharm"},{"key":"lt25390-bib-0039-20240115","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/j.1600-6143.2008.02493.x","article-title":"Delayed introduction of reduced\u2010dose tacrolimus, and renal function in liver transplantation: the \u2018ReSpECT\u2019 study","volume":"9","year":"2009","journal-title":"Am J Transplant"},{"key":"lt25390-bib-0040-20240115","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1002\/hep.24385","article-title":"Interleukin 2 receptor antagonists for liver transplant recipients: a systematic review and meta\u2010analysis of controlled studies","volume":"54","year":"2011","journal-title":"Hepatology"},{"key":"lt25390-bib-0041-20240115","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1097\/TP.0b013e318218f0f5","article-title":"Basiliximab induction and delayed calcineurin inhibitor initiation in liver transplant recipients with renal insufficiency","volume":"91","year":"2011","journal-title":"Transplantation"},{"key":"lt25390-bib-0042-20240115","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1136\/gut.2008.163527","article-title":". Immunosuppression for liver transplantation","volume":"58","year":"2009","journal-title":"Gut"},{"key":"lt25390-bib-0043-20240115","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1056\/NEJMoa074191","article-title":"Tolerance and chimerism after renal and hematopoietic\u2010cell transplantation","volume":"358","year":"2008","journal-title":"N Engl J Med"},{"key":"lt25390-bib-0044-20240115","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1056\/NEJMoa0707255","article-title":"Chimerism and tolerance in a recipient of a deceased\u2010donor liver transplant","volume":"358","year":"2008","journal-title":"N Engl J Med"},{"key":"lt25390-bib-0045-20240115","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1002\/lt.20680","article-title":"The effect of HLA class I (A and B) and class II (DR) compatibility on liver transplantation outcomes: an analysis of the OPTN database","volume":"12","year":"2006","journal-title":"Liver Transpl"},{"key":"lt25390-bib-0046-20240115","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1002\/lt.20521","article-title":"The effect of HLA mismatches, shared cross\u2010reactive antigen groups, and shared HLA\u2010DR antigens on the outcome after pediatric liver transplantation","volume":"11","year":"2005","journal-title":"Liver Transpl"},{"key":"lt25390-bib-0047-20240115","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s40472-015-0052-y","article-title":"The cost of transplant immunosuppressant therapy: is this sustainable?","volume":"2","year":"2015","journal-title":"Curr Transplant Rep"},{"key":"lt25390-bib-0048-20240115","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1093\/ndt\/gfw368","article-title":"Anti\u2010thymocyte globulins in kidney transplantation: focus on current indications and long\u2010term immunological side effects","volume":"32","year":"2017","journal-title":"Nephrol Dial Transplant"},{"key":"lt25390-bib-0049-20240115","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1681\/ASN.V133769","article-title":"Association of antibody induction with short\u2010 and long\u2010term cause\u2010specific mortality in renal transplant recipients","volume":"13","year":"2002","journal-title":"J Am Soc Nephrol"},{"key":"lt25390-bib-0050-20240115","doi-asserted-by":"crossref","first-page":"2859","DOI":"10.1016\/S0041-1345(98)00843-4","article-title":"CD4 lymphocytopenia in long\u2010term renal transplant recipients","volume":"30","year":"1998","journal-title":"Transplant Proc"},{"key":"lt25390-bib-0051-20240115","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/ajt.13092","article-title":"ATG\u2010induced accelerated immune senescence: clinical implications in renal transplant recipients","volume":"15","year":"2015","journal-title":"Am J Transplant"},{"key":"lt25390-bib-0052-20240115","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1097\/QAD.0b013e3280108704","article-title":"Increased carotid intima\u2010media thickness in HIV patients is associated with increased cytomegalovirus\u2010specific T\u2010cell responses","volume":"20","year":"2006","journal-title":"AIDS"},{"key":"lt25390-bib-0053-20240115","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1056\/NEJMoa060068","article-title":"Rabbit antithymocyte globulin versus basiliximab in renal transplantation","volume":"355","year":"2006","journal-title":"N Engl J Med"},{"key":"lt25390-bib-0054-20240115","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1097\/SLA.0b013e31817fc2b8","article-title":"The combined organ effect: protection against rejection?","volume":"248","year":"2008","journal-title":"Ann Surg"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.25390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201903000-00012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T07:57:58Z","timestamp":1775289478000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201903000-00012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,28]]},"references-count":53,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.25390","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,28]]}}}