{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:16Z","timestamp":1773878416536,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,1,30]],"date-time":"2014-01-30T00:00:00Z","timestamp":1391040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While kidney transplant recipients of <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frican <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merican (<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>) descent are frequently considered at increased risk of acute rejection, the value of induction therapy is not defined in settings of lower immunologic risk and modern immunosuppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>cientific <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>egistry of <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>ransplant <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ecipients database, we identified 23\u00a0244 primary kidney transplant recipients with panel\u2010reactive antibody (<jats:styled-content style=\"fixed-case\">PRA<\/jats:styled-content>)\u00a0=\u00a00% treated with <jats:styled-content style=\"fixed-case\">TAC<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> and prednisone from 2000 to 2008. We compared acute rejection, graft survival (<jats:styled-content style=\"fixed-case\">GS<\/jats:styled-content>), and patient survival rates among <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> and non\u2010<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> and further stratified by induction therapy (none, <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>2ra, or r<jats:styled-content style=\"fixed-case\">ATG<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One\u2010yr acute rejection was higher in <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> than in non\u2010<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> overall (14.5% vs. 9.9%, hazard ratio [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>] for acute rejection [<jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content>] 1.43, p\u00a0&lt;\u00a00.0001) and was higher regardless of induction agent use. Induction therapy was associated with a reduction in <jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content>, but no benefit in <jats:styled-content style=\"fixed-case\">GS<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> or non\u2010<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>. In <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>, r<jats:styled-content style=\"fixed-case\">ATG<\/jats:styled-content> (adjusted relative risk [<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>] 0.81, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.70\u20130.94) and <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>2ra (adjusted <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.80, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.68\u20130.93) were similarly effective in reducing <jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content> rates, but did not reach comparable outcomes as in non\u2010<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frican <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>mericans who are at otherwise lower immunologic risk have a higher risk of rejection despite modern immunosuppression. Depleting or non\u2010depleting induction therapy similarly reduces but does not entirely mitigate this increased risk, with no impact on three\u2010yr <jats:styled-content style=\"fixed-case\">GS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12311","type":"journal-article","created":{"date-parts":[[2014,1,30]],"date-time":"2014-01-30T07:44:38Z","timestamp":1391067878000},"page":"292-298","source":"Crossref","is-referenced-by-count":19,"title":["The risk of acute rejection and the influence of induction agents in lower\u2010risk <scp>A<\/scp>frican <scp>A<\/scp>merican kidney transplant recipients receiving modern immunosuppression"],"prefix":"10.1111","volume":"28","author":[{"given":"Jane","family":"Gralla","sequence":"first","affiliation":[{"name":"Transplant Center University of Colorado Denver Aurora CO USA"},{"name":"Department of Pediatrics University of Colorado Denver Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles N.","family":"Le","sequence":"additional","affiliation":[{"name":"Transplant Center University of Colorado Denver Aurora CO USA"},{"name":"Division of Renal Diseases and Hypertension University of Colorado Denver Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Transplant Center University of Colorado Denver Aurora CO USA"},{"name":"Division of Renal Diseases and Hypertension University of Colorado Denver Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander C.","family":"Wiseman","sequence":"additional","affiliation":[{"name":"Transplant Center University of Colorado Denver Aurora CO USA"},{"name":"Division of Renal Diseases and Hypertension University of Colorado Denver Aurora CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,1,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199201000-00012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199711150-00008"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000061228.38243.26"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199607270-00021"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200107270-00017"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011233432107"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011233432106"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004121059"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03283.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199901150-00019"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199801153380304"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2002.020109.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa060068"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008101037"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318187d1da"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009546"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ea6788"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2009.01004.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)80713-X"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1600-6135.2003.00243.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03927.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01658.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067411"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"}],"container-title":["Clinical 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