{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:35:31Z","timestamp":1779273331255,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The use of induction immunosuppression for heart transplantation (HT) is debated given the uncertain benefit and potential risks of infection and malignancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective single\u2010center analysis of 475 consecutive HT recipients from 2003 to 2020 grouped by use of induction with basiliximab group (BG) and the no basiliximab group (NBG). Subgroup analysis by era compared pre\u20102016 standard\u2010basiliximab (BX) induction and 2016\u20132020 with selective\u2010BX use as part of a calcineurin\u2010inhibitor\u2010sparing regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>When adjusted for confounders (sex, age, PRA, eGFR), the BG was less likely to have acute cellular rejection (ACR) (OR.42, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), but had more antibody mediated rejection (AMR) (OR 11.7, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) and more cardiac allograft vasculopathy (CAV) (OR 3.8, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04). There was no difference between BG and NBG in the incidence of malignancies or infections. When stratified by era (pre\u20102016\u00a0vs. 2016\u20132020), ACR remained less common in the BG than the NBG (36%\u00a0vs. 50%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.045) groups, while AMR remained more common (9.7\u00a0vs. 0% <jats:italic>p<\/jats:italic>\u00a0=\u00a0.005). There was no significant difference in conditional survival comparing pre\u2010and post\u20102016 NBG (HR 2.20 (95% CI.75\u20136.43); however, both pre\u20102016 BG and post\u20102016 BG have significantly higher mortality (HR 2.37 [95% CI 1.02\u20135.50) and HR 2.69 (95% CI 1.08\u20136.71), <jats:italic>p<\/jats:italic>\u00a0=\u00a0.045 and.03, respectively].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Basiliximab reduces the incidence of ACR but increases the risk of AMR, CAV, and may be associated with increased mortality. Mechanistic studies are needed to describe a potential T\u2010cell\u2010escape mechanism with enhanced humoral immunity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15307","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T12:38:34Z","timestamp":1712147914000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A heart transplant center experience with basiliximab induction strategies: A double edged sword?"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7908-4611","authenticated-orcid":false,"given":"Luise","family":"Holzhauser","sequence":"first","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-1050","authenticated-orcid":false,"given":"Maxwell","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2277-247X","authenticated-orcid":false,"given":"Maria","family":"Molina","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8931-3294","authenticated-orcid":false,"given":"Susan","family":"Chambers","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4668-7672","authenticated-orcid":false,"given":"Swethika","family":"Sundaravel","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6081-2137","authenticated-orcid":false,"given":"Eman","family":"Rashed","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6762-7412","authenticated-orcid":false,"given":"Ketan","family":"Gala","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7295-6261","authenticated-orcid":false,"given":"Tara","family":"Fallah","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8576-0193","authenticated-orcid":false,"given":"Therese","family":"Bittermann","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2942-3731","authenticated-orcid":false,"given":"Nosheen","family":"Reza","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4755-4129","authenticated-orcid":false,"given":"Teresa","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0229-085X","authenticated-orcid":false,"given":"Pavan","family":"Atluri","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7906-9638","authenticated-orcid":false,"given":"Lee","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6979-6762","authenticated-orcid":false,"given":"Rhondalyn","family":"McLean","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3350-3136","authenticated-orcid":false,"given":"Eliot","family":"Peyster","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.10.015"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741\u2010018\u20109691\u20102"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13871"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008842"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2006.077180"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2004.01.002"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14937"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.04.001"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.12469"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.01.008"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003023420902"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.115.002252"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.11.004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201080567\u20109"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.04.056"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13480"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13904"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12481"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2004.09.010"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.15307","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T11:10:02Z","timestamp":1713784202000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.15307"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/ctr.15307"],"URL":"https:\/\/doi.org\/10.1111\/ctr.15307","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-12-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15307"}}