{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T14:07:02Z","timestamp":1779372422382,"version":"3.53.1"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>In kidney transplantation, induction therapy is often selected based on perceived immunologic risk for acute rejection, commonly considering African American (AA) ethnicity, panel reactive antibody (PRA) levels &gt; 20%, and retransplantation.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Compare post-transplant outcomes in African American kidney transplant recipients between two induction agents, rabbit anti-thymocyte globulin (rATG) and basiliximab and followed long-term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective study included 173 AA KTRs followed for a mean of 39.7 \u00b1 26.3 months. Patients received induction with either rATG (n = 71, 41%) or basiliximab (n = 102, 59%). All recipients were maintained on calcineurin inhibitor\u2013based triple immunosuppression. Backward stepwise regression was used to obtain final adjusted models, and time to graft loss was analyzed using Cox proportional hazards regression (STATA 15).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were no significant differences in overall graft survival (p = 0.75), or death censored graft survival (p=0.28), between the two induction groups. The incidence of first biopsy-proven acute rejection (BPAR) was similar (p = 0.14). Compared with basiliximab, rATG induction significantly increased the risk of viral infections (p = 0.019), bacterial infections (p = 0.025), and overall infections (p = 0.035). Infections were a risk factor for late graft loss (p = 0.039).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among AA kidney transplant recipients, the use of depleting induction therapy with rATG did not confer benefit for graft or patient survival in the intermediate and long-term but was associated with a significantly higher risk of post-transplant infections. These findings suggest that the use of depleting antibody induction should be carefully balanced against infection risk and that risk stratification based solely on ethnicity should be reconsidered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121261450794","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T17:50:36Z","timestamp":1779213036000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Toward equitable transplant protocols: Thymoglobulin vs. Basiliximab in African-American kidney transplantation shows higher infection risk without survival benefit"],"prefix":"10.1177","volume":"14","author":[{"given":"Lucas","family":"Tobar","sequence":"first","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mareena","family":"Zachariah","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2702-7476","authenticated-orcid":false,"given":"Piruthiviraj","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranatharthi H.","family":"Chandrasekar","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakir","family":"Hussein","sequence":"additional","affiliation":[{"name":"Charleston Area Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Wilpula","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Wolff","sequence":"additional","affiliation":[{"name":"Harper University Hospital - Detroit Medical Center, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indika","family":"Mallawaarachchi","sequence":"additional","affiliation":[{"name":"Data Science Institute, University of Virginia, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000153506.07816.F0"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2009.153"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15342"},{"issue":"3","key":"e_1_3_6_5_2","first-page":"319","article-title":"Thymoglobulin--new approaches to optimal outcomes","volume":"2","author":"Moicean AD","year":"2009","unstructured":"Moicean AD, Popp AM, Sinescu I. 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