{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T23:14:19Z","timestamp":1787181259563,"version":"build-2736575974"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2020,1]]},"abstract":"\n Background:<\/jats:title>\n Kidney transplant recipients are given induction therapy to rapidly reduce the immune response and prevent rejection. Guidelines recommend that an interleukin-2 receptor antibody (basiliximab) be the first-line agent and that a lymphocyte-depleting agent (antithymocyte globulin [ATG]) be reserved for those at high immunologic risk.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To determine the incidence, risk factors, and outcomes for patients who receive both basiliximab and ATG for induction compared to either agent alone.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n We used the transplant electronic medical record at the University of Alberta Hospital in Edmonton, Canada.<\/jats:p>\n <\/jats:sec>\n \n Patients\/samples\/participants:<\/jats:title>\n We included incident adult kidney transplant recipients from 2013 to 2018.<\/jats:p>\n <\/jats:sec>\n \n Measurements:<\/jats:title>\n We measured baseline characteristics, type, and dose of induction therapy used, estimated glomerular filtration rate (eGFR) at 1-year posttransplant, and outcomes of all-cause graft failure, death-censored graft failure, all-cause mortality, and death with a functioning graft.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Differences between induction groups were compared using chi-square test for categorical variables and Kruskal-Wallis tests for continuous variables. We performed multivariable logistic regression modeling with type of induction therapy as the dependent variable and the case-level factors as the predictors (adjusted odds ratio). We estimated the Kaplan-Meier failure functions and used log-rank tests to assess statistical significance of differences in unadjusted incidence across induction therapy types. We compared cumulative incidence functions using a Fine and Gray competing risk regression model.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In all, 430 kidney transplant recipients were followed for a mean of 3.9 years (standard deviation 1.5). Of these, 71% (n = 305) received basiliximab alone, 22% (n = 93) received ATG alone, and 7% (n = 32) received both basiliximab and ATG. After adjusting for age and sex, compared to the basiliximab alone group, patients were more likely to receive dual-induction therapy if they were sensitized (calculated panel reactive antibody \u226580%), had diabetes mellitus or peripheral vascular disease, or experienced delayed graft function. Compared to the ATG alone group, the dual-induction therapy group had worse graft function at 1 year (mean eGFR 42 vs. 59 mL\/min\/1.73 m\n 2<\/jats:sup>\n , P = .0008) and an increased risk of all-cause graft failure (31% vs. 13%, P = .02) and death-censored graft failure (16% vs. 4%, P = .03).\n <\/jats:p>\n <\/jats:sec>\n \n Limitations:<\/jats:title>\n There is a risk of confounding by indication, as patients who received dual-induction therapy likely had worse outcomes due to the indication for dual-induction therapy (such as delayed graft function).<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n In our study, 1 out of 10 recipients who were treated with basiliximab also received ATG for induction therapy. These patients experienced worse outcomes than those treated with ATG alone.<\/jats:p>\n <\/jats:sec>\n \n Trial registration:<\/jats:title>\n Not applicable (cohort study).<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/2054358120964061","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T08:32:48Z","timestamp":1602750768000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Incidence, Risk Factors, and Outcomes of Kidney Transplant Recipients Treated With Both Basiliximab and Antithymocyte Globulin"],"prefix":"10.1177","volume":"7","author":[{"given":"Rachel","family":"Jeong","sequence":"first","affiliation":[{"name":"Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R.","family":"Quinn","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada"},{"name":"Department of Community Health Sciences, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista L.","family":"Lentine","sequence":"additional","affiliation":[{"name":"Center for Abdominal Transplantation, Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6973-8570","authenticated-orcid":false,"given":"Pietro","family":"Ravani","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada"},{"name":"Department of Community Health Sciences, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Broscheit","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Alberta Hospital, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sita","family":"Gourishankar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0129-7091","authenticated-orcid":false,"given":"Ngan N.","family":"Lam","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada"},{"name":"Department of Community Health Sciences, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"bibr1-2054358120964061","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02655.x"},{"key":"bibr2-2054358120964061","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2010.05.004"},{"key":"bibr3-2054358120964061","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa060068"},{"key":"bibr4-2054358120964061","first-page":"CD003897","author":"Webster AC","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr5-2054358120964061","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13079"},{"key":"bibr6-2054358120964061","unstructured":"University of Alberta. Renal transplantation. https:\/\/www.ualberta.ca\/department-of-medicine\/education\/residency-programs\/nephrology\/rotations\/renal-transplantation.html. Accessed May 11, 2020."},{"key":"bibr7-2054358120964061","unstructured":"Edmonton Sun. University of Alberta hospital celebrates 50 years of kidney transplants. https:\/\/edmontonsun.com\/2017\/01\/26\/university-of-alberta-hospital-celebrates-50-years-of-kidney-transplants\/wcm\/a5d71d09-1cb9-4e61-ab1a-c475b2e32c13. 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