Evans RDR, Lan JH, Kadatz M, Brar S, Chang DT, McMichael L, Gill J, Gill JS: Use and outcomes of induction therapy in well-matched kidney transplant recipients. Clin J Am Soc Nephrol 17: , 2022.
Throughout the article, the authors reported cells with fewer than 11 patients. However, per the data use agreement with the United States Renal Data System, cells with fewer than 11 cells must be supressed. In the Results section, the sentence “Among patients treated with IL2-RAs, 99% (n=826) received basiliximab, and 1% (n=10) received daclizumab.” should instead appear as “Among patients treated with IL2-RAs, 99% (n=826) received basiliximab.” The corrected Table 1, Table 2, and Supplemental Tables 2 and 6 appear below.
Table 1. -
Patient characteristics
| Patient Characteristic |
T Cell–Depleting Antibodies, n=1689 |
IL-2 Receptor Antagonists,
a
n=836 |
No Induction, n=451 |
| Median age, yr (quartile 1 to quartile 3) |
53 (42–62) |
53 (41–63) |
53 (41–61) |
| Men, n (%) |
743 (44) |
516 (62) |
264 (59) |
|
Recipient race, n (%)
|
|
|
|
| White |
1388 (82) |
698 (83) |
375 (83) |
| Black |
213 (13) |
83 (10) |
47 (10) |
| Other |
88 (5) |
55 (7) |
29 (6) |
| Diabetes-related kidney failure, n (%) |
452 (27) |
197 (24) |
118 (26) |
|
cPRA, n (%)
|
|
|
|
| 0 |
661 (39) |
551 (66) |
254 (56) |
| 1–29 |
215 (13) |
115 (14) |
46 (10) |
| 30–79 |
413 (24) |
114 (14) |
101 (22) |
| 80–97 |
258 (15) |
36 (4) |
30 (7) |
| 98–100 |
142 (8) |
20 (2) |
20 (4) |
|
Insurance, n (%)
|
|
|
|
| Medicare |
884 (52) |
381 (46) |
199 (44) |
| Private |
538 (32) |
275 (33) |
143 (32) |
| Other |
266 (16) |
180 (22) |
109 (24) |
| Duration of pretransplant dialysis, yr (quartile 1 to quartile 3) |
2 (0–3) |
1 (0–3) |
1 (0–3) |
|
Maintenance immunosuppression, n (%)
|
|
|
|
| Corticosteroids |
1635 (97) |
818 (98) |
387 (86) |
| Maintenance tacrolimus |
1568 (93) |
774 (93) |
411 (91) |
| Maintenance antimetabolite
b
|
1613 (96) |
807 (97) |
409 (91) |
| Delayed graft function, n (%) |
229 (14) |
74 (9) |
32 (7) |
| Median hospitalization, d (quartile 1 to quartile 3) |
5 (4–6) |
4 (4–5) |
4 (4–6) |
| eGFR at 6 mo (quartile 1 to quartile 3) |
51 (38–68) |
54 (40–71) |
51 (40–71) |
| Early graft loss (%) |
14 (0.8) |
|
|
|
Donor characteristics, n (%)
|
|
|
|
| Living donor |
434 (26) |
421 (50) |
227 (50) |
|
Living related
c
|
423 (25) |
410 (49) |
221 (49) |
|
Living unrelated
|
|
|
|
| Deceased donor |
1255 (74) |
415 (50) |
224 (50) |
|
Neurologic brain death
|
1154 (92) |
379 (91) |
204 (91) |
|
Donation after circulatory death
|
101 (8) |
36 (9) |
20 (9) |
|
Deceased donor KDPI, n (%)
|
|
|
|
| 0–20 |
403 (32) |
117 (28) |
83 (37) |
| 21–50 |
466 (37) |
176 (42) |
82 (37) |
| 51–85 |
341 (27) |
109 (26) |
53 (24) |
| 86–100 |
45 (4) |
13 (3) |
|
| Cold ischemic time ≥18 h (%) |
697 (41) |
149 (18) |
104 (23) |
Data are suppressed due to 11 or fewer cells. cPRA, calculated panel reactive antibody; KDPI, kidney donor profile index.
aIL-2 receptor antagonist included 826 patients treated with basiliximab and ten patients treated with daclizumab.
bAntimetabolites: Imuran (n=15), CellCept, myfortic, generic mycophenolate mofetil, and generic myfortic.
cLiving related donors include sibling, child, or parent donors.
Table 2. -
Association of induction therapy with the outcomes of graft loss from any cause, including death, graft loss censored for death, and death with a functioning graft
| Patient Characteristic |
No. (%) with Outcome |
Graft Loss from Any Cause, Hazard Ratio (95% Confidence Interval) |
No. (%) with Outcome |
Graft Loss Censored for Death, Hazard Ratio (95% Confidence Interval) |
No. (%) with Outcome |
Death with Functioning Graft, Hazard Ratio (95% Confidence Interval) |
|
Induction therapy
|
|
|
|
|
|
|
| IL2-RAsa/no induction |
304 (18) |
Reference |
163 (10) |
Reference |
141 (8) |
Reference |
| Depleting antibody |
171 (13) |
1.19 (0.98 to 1.45) |
75 (6) |
1.46 (1.09 to 1.94) |
96 (8) |
0.97 (0.13 to 1.27) |
|
Age at transplant, yr
|
|
|
|
|
|
|
| 18–39 |
67 (11) |
Reference |
56 (9) |
Reference |
11 (2) |
Reference |
| 40–60 |
215 (14) |
1.11 (0.84 to 1.47) |
118 (8) |
0.72 (0.52 to 1.00) |
97 (7) |
3.08 (1.64 to 5.78) |
| 61+ |
193 (23) |
1.61 (1.20 to 2.16) |
64 (8) |
0.62 (0.42 to 0.91) |
129 (15) |
6.42 (3.42 to 12.06) |
| Men |
253 (17) |
1.31 (1.06 to 1.61) |
124 (8) |
1.23 (0.93 to 1.64) |
129 (8) |
1.33 (0.99 to 1.80) |
|
Recipient race
|
|
|
|
|
|
|
| White |
394 (16) |
Reference |
194 (8) |
Reference |
200 (8) |
Reference |
| Black |
64 (19) |
1.18 (0.90 to 1.54) |
34 (10) |
1.20 (0.83 to 1.75) |
30 (9) |
1.17 (0.79 to 1.72) |
| Other |
17 (10) |
0.68 (0.42 to 1.10) |
|
0.84 (0.44 to 1.59) |
|
0.58 (0.27 to 1.23) |
| Diabetes |
183 (24) |
1.55 (1.28 to 1.88) |
78 (10) |
1.30 (0.98 to 1.73) |
105 (14) |
1.72 (1.33 to 2.24) |
|
Insurance
|
|
|
|
|
|
|
| Medicare |
277 (19) |
Reference |
118 (8) |
Reference |
159 (11) |
Reference |
| Private |
136 (14) |
0.91 (0.74 to 1.13) |
79 (8) |
1.19 (0.88 to 1.62) |
57 (6) |
0.69 (0.51 to 0.94) |
| Other |
62 (11) |
0.87 (0.66 to 1.17) |
41 (7) |
1.14 (0.78 to 1.66) |
21 (4) |
0.61 (0.38 to 0.98) |
| Duration of pretransplant dialysis |
|
1.03 (1.00 to 1.06) |
|
1.00 (0.94 to 1.05) |
|
1.05 (1.01 to 1.09) |
|
cPRA
|
|
|
|
|
|
|
| 0 |
203 (14) |
Reference |
103 (7) |
Reference |
100 (7) |
Reference |
| 1–29 |
57 (15) |
0.89 (0.66 to 1.20) |
27 (7) |
0.83 (0.54 to 1.28) |
30 (8) |
0.98 (0.65 to 1.49) |
| 30–79 |
119 (19) |
1.10 (0.86 to 1.41) |
62 (10) |
1.11 (0.79 to 1.56) |
57 (9) |
1.06 (0.75 to 1.51) |
| 80–97 |
63 (19) |
1.18 (0.86 to 1.62) |
32 (10) |
1.05 (0.68 to 1.64) |
31 (10) |
1.33 (0.84 to 2.11) |
| 98–100 |
33 (18) |
1.08 (0.72 to 1.62) |
14 (8) |
0.86 (0.47 to 1.57) |
19 (10) |
1.30 (0.75 to 2.25) |
| KDPI living donor |
|
Reference |
|
Reference |
|
Reference |
| Deceased donor KDPI: 0–85 |
91 (8) |
2.08 (1.61 to 2.69) |
49 (5) |
2.42 (1.69 to 3.47) |
42 (4) |
1.66 (1.15 to 2.41) |
| Deceased donor KDPI: 86–100 |
365 (20) |
3.36 (2.01 to 5.63) |
182 (10) |
3.04 (1.33 to 6.93) |
183 (10) |
2.77 (1.43 to 5.39) |
Data are suppressed due to 11 or fewer cells. IL2-RA, IL-2 receptor antagonist; cPRA, calculated panel reactive antibody; KDPI, kidney donor profile index.
Supplemental Table 2. -
Association of induction therapy (no induction group as reference) with outcomes of graft loss from any cause of death, graft loss censored for death, and death with functioning graft
|
Graft Loss from Any Cause |
Graft Loss Censored for Death |
Death with Functioning Graft |
|
Number (%) with Outcome |
HR (95% CI) |
Number (%) with Outcome |
HR (95% CI) |
Number (%) with Outcome |
HR (95% CI) |
|
Induction therapy
|
| No |
61 (14) |
Reference |
28 (6) |
Reference |
33 (7) |
|
|
Induction
|
| IL2-RAs |
110 (13) |
1.01 (0.73 to 1.38) |
47 (6) |
0.94 (0.58 to 1.50) |
63 (8) |
1.08 (0.71 to 1.65) |
| Depleting antibody |
304 (18) |
1.19 (0.90 to 1.58) |
163 (10) |
1.40 (0.93 to 2.10) |
141 (8) |
1.01 (0.69 to 1.49) |
|
Age at transplant
|
| 18–39 |
67 (11) |
Reference |
56 (9) |
Reference |
11 (2) |
Reference |
| 40–60 |
125 (14) |
1.11 (0.84 to 1.47) |
118 (8) |
0.72 (0.52 to 1.00) |
97 (6) |
3.08 (1.64 to 5.78) |
| 61+ |
193 (23) |
1.61 (1.20 to 2.16) |
64 (8) |
0.62 (0.42 to 0.91) |
129 (15) |
6.42 (3.42 to 12.06) |
| Male, sex |
253 (17) |
1.31 (1.06 to 1.61) |
124 (8) |
1.23 (0.93 to 1.64) |
129 (8) |
1.33 (0.99 to 1.80) |
|
Recipient race
|
| White |
394 (16) |
Reference |
194 (8) |
Reference |
200 (8) |
Reference |
| Black |
64 (19) |
1.18 (0.90 to 1.54) |
34 (10) |
1.20 (0.83 to 1.75) |
30 (9) |
1.17 (0.79 to 1.72) |
| Other |
17 (10) |
0.68 (0.42 to 1.10) |
|
0.84 (0.44 to 1.59) |
|
0.58 (0.27 to 1.23) |
| Diabetes |
183 (24) |
1.55 (1.28 to 1.88) |
78 (10) |
1.30 (0.98 to 1.73) |
105 (14) |
1.72 (1.33 to 2.24) |
|
Insurance
|
| Medicare |
277 (19) |
Reference |
118 (8) |
Reference |
159 (11) |
Reference |
| Private |
136 (14) |
0.91 (0.74 to 1.13) |
79 (8) |
1.19 (0.88 to 1.62) |
57 (6) |
0.69 (0.51 to 0.94) |
| Other |
62 (11) |
0.87 (0.66 to 1.17) |
41 (7) |
1.14 (0.78 to 1.66) |
21 (4) |
0.61 (0.38 to 0.98) |
| Duration of pretransplant dialysis |
— |
1.03 (1.00 to 1.06) |
— |
1.00 (0.94 to 1.05) |
— |
1.05 (1.01 to 1.09) |
|
cPRA
|
| 0 |
203 (14) |
Reference |
103 (7) |
Reference |
100 (7) |
Reference |
| 1–29 |
57 (15) |
0.89 (0.66 to 1.20) |
27 (7) |
0.83 (0.54 to 1.28) |
30 (8) |
0.98 (0.65 to 1.49) |
| 30–79 |
119 (19) |
1.10 (0.86 to 1.41) |
62 (10) |
1.11 (0.79 to 1.56) |
57 (9) |
1.06 (0.75 to 1.51) |
| 80–97 |
63 (19) |
1.18 (0.86 to 1.62) |
32 (10) |
1.05 (0.68 to 1.64) |
31 (10) |
1.33 (0.84 to 2.11) |
| 98–100 |
33 (18) |
1.08 (0.72 to 1.62) |
14 (8) |
0.86 (0.47 to 1.57) |
19 (10) |
1.30 (0.75 to 2.25) |
|
Donor type
|
|
|
|
|
|
|
| Living donor |
91 (8) |
Reference |
49 (5) |
Reference |
42 (4) |
Reference |
| Deceased donor KDPI: 0–85 |
365 (20) |
2.08 (1.61 to 2.69) |
182 (10) |
2.42 (1.69 to 3.47) |
183 (10) |
1.66 (1.15 to 2.41) |
| Deceased donor KDPI: 86–100 |
19 (30) |
3.36 (2.01 to 5.63) |
|
3.04 (1.33 to 6.93) |
12 (19) |
2.77 (1.43 to 5.39) |
HR, hazard ratio; 95% CI, 95% confidence interval; IL2-RAs, interleukin-2 receptor antagonists; cPRA, calculated panel reactive antibody; KDPI, kidney donor profile index.
Supplemental Table 6. -
Risk table for
Supplemental Figure 2 (DCD donors)
|
Time Post-Transplant |
|
0 Year |
1 Year |
2 Years |
3 Years |
4 Years |
5 Years |
|
A. Graft loss from any cause
|
| T-cell depleting |
101 |
94 |
89 |
87 |
57 |
32 |
| IL2-RAs |
36 |
34 |
32 |
32 |
22 |
11 |
| No induction |
20 |
19 |
17 |
17 |
11 |
|
|
B. Death-censored graft loss
|
| T-cell depleting |
101 |
97 |
94 |
93 |
65 |
39 |
| IL2-RAs |
36 |
35 |
35 |
35 |
26 |
14 |
| No induction |
20 |
20 |
19 |
19 |
12 |
|
|
C. Death with a functioning graft
|
| T-cell depleting |
101 |
98 |
96 |
95 |
62 |
35 |
| IL2-RAs |
36 |
35 |
33 |
33 |
23 |
11 |
| No induction |
20 |
19 |
18 |
18 |
11 |
|
