The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience
Background. Immunosuppressive therapy is the backbone of kidney transplantation in preventing acute rejection. T-cell depletion after doses of thymoglobulin is dose-dependent, as are their side effects. At the same time, basiliximab and other maintenance immunosuppressive drugs act at different sign...
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my.um.eprints.429692023-10-05T04:05:18Z http://eprints.um.edu.my/42969/ The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience Jalalonmuhali, Maisarah Ng, Kok Peng Lee, Yee Wan Gan, Chye Chung Hing, Albert (Wong) Wan Md Adnan, Wan Ahmad Hafiz Cheng, Shian Feng Chew, Chang Chuan Ooi, Shok Hoon Wong, Chew Ming Lim, Soo Kun R Medicine RD Surgery Background. Immunosuppressive therapy is the backbone of kidney transplantation in preventing acute rejection. T-cell depletion after doses of thymoglobulin is dose-dependent, as are their side effects. At the same time, basiliximab and other maintenance immunosuppressive drugs act at different signals on T lymphocytes. Therefore, studying the pattern of lymphocyte subset depletion depending on the induction regime given at transplantation could be an added tool in managing post-transplant recipients.& nbsp;Methodology. This prospective observational study recruited kidney transplant recipients from August 2019 through April 2021 at the University of Malaya Medical Centre. Blood tests for lymphocyte subsets were taken at pre-transplant, 1 week, 1 month, 3 months, and 6 months post-transplantation. At transplantation, recipients received either basiliximab, low-dose thymoglobulin (cumulative dose: 1.5 mg/kg), or standard-dose thymoglobulin (cumulative dose: 5 mg/kg).& nbsp;Results. A total of 39 patients were recruited: 38.5% received basiliximab (15 of 39), 15.4% received low-dose thymoglobulin (6 of 39), and 46.2% received standard-dose thymoglobulin (18 of 39). Absolute lymphocyte counts 1 week post-transplantation were 1.5 +/- 0.84 x 10(9)/L for basiliximab, 0.7 +/-& nbsp;0.57 x 10(9)/L for low-dose thymoglobulin, and 0.1 +/- 0.08 x 10(9)/L for standard-dose thymoglobulin (P < .001). The CD4+ and CD8+ counts were severely depleted in the standard-dose thymoglobulin group, with a statistically significant differenceup to 6 months post-transplantation. In the low-dose thymoglobulin group, the CD4+ and CD8+ counts were depleted at 1 week post-transplantation and recovered at 1 month post-transplantation. There was no difference in allograft function and incidence of allograft rejection across groups.& nbsp;Conclusions. The effects on lymphocyte counts, CD4+ and CD8+, vary depending on the type and dose of induction immunosuppression. This could be a guiding tool in managing immunosuppression post-transplantation depending on the patient's immunologic risk. Elsevier Science Inc 2022-03 Article PeerReviewed Jalalonmuhali, Maisarah and Ng, Kok Peng and Lee, Yee Wan and Gan, Chye Chung and Hing, Albert (Wong) and Wan Md Adnan, Wan Ahmad Hafiz and Cheng, Shian Feng and Chew, Chang Chuan and Ooi, Shok Hoon and Wong, Chew Ming and Lim, Soo Kun (2022) The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience. Transplantation Proceedings, 54 (2). pp. 299-306. ISSN 0041-1345, DOI https://doi.org/10.1016/j.transproceed.2022.01.004 <https://doi.org/10.1016/j.transproceed.2022.01.004>. 10.1016/j.transproceed.2022.01.004 |
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R Medicine RD Surgery Jalalonmuhali, Maisarah Ng, Kok Peng Lee, Yee Wan Gan, Chye Chung Hing, Albert (Wong) Wan Md Adnan, Wan Ahmad Hafiz Cheng, Shian Feng Chew, Chang Chuan Ooi, Shok Hoon Wong, Chew Ming Lim, Soo Kun The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience |
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Background. Immunosuppressive therapy is the backbone of kidney transplantation in preventing acute rejection. T-cell depletion after doses of thymoglobulin is dose-dependent, as are their side effects. At the same time, basiliximab and other maintenance immunosuppressive drugs act at different signals on T lymphocytes. Therefore, studying the pattern of lymphocyte subset depletion depending on the induction regime given at transplantation could be an added tool in managing post-transplant recipients.& nbsp;Methodology. This prospective observational study recruited kidney transplant recipients from August 2019 through April 2021 at the University of Malaya Medical Centre. Blood tests for lymphocyte subsets were taken at pre-transplant, 1 week, 1 month, 3 months, and 6 months post-transplantation. At transplantation, recipients received either basiliximab, low-dose thymoglobulin (cumulative dose: 1.5 mg/kg), or standard-dose thymoglobulin (cumulative dose: 5 mg/kg).& nbsp;Results. A total of 39 patients were recruited: 38.5% received basiliximab (15 of 39), 15.4% received low-dose thymoglobulin (6 of 39), and 46.2% received standard-dose thymoglobulin (18 of 39). Absolute lymphocyte counts 1 week post-transplantation were 1.5 +/- 0.84 x 10(9)/L for basiliximab, 0.7 +/-& nbsp;0.57 x 10(9)/L for low-dose thymoglobulin, and 0.1 +/- 0.08 x 10(9)/L for standard-dose thymoglobulin (P < .001). The CD4+ and CD8+ counts were severely depleted in the standard-dose thymoglobulin group, with a statistically significant differenceup to 6 months post-transplantation. In the low-dose thymoglobulin group, the CD4+ and CD8+ counts were depleted at 1 week post-transplantation and recovered at 1 month post-transplantation. There was no difference in allograft function and incidence of allograft rejection across groups.& nbsp;Conclusions. The effects on lymphocyte counts, CD4+ and CD8+, vary depending on the type and dose of induction immunosuppression. This could be a guiding tool in managing immunosuppression post-transplantation depending on the patient's immunologic risk. |
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Jalalonmuhali, Maisarah Ng, Kok Peng Lee, Yee Wan Gan, Chye Chung Hing, Albert (Wong) Wan Md Adnan, Wan Ahmad Hafiz Cheng, Shian Feng Chew, Chang Chuan Ooi, Shok Hoon Wong, Chew Ming Lim, Soo Kun |
author_facet |
Jalalonmuhali, Maisarah Ng, Kok Peng Lee, Yee Wan Gan, Chye Chung Hing, Albert (Wong) Wan Md Adnan, Wan Ahmad Hafiz Cheng, Shian Feng Chew, Chang Chuan Ooi, Shok Hoon Wong, Chew Ming Lim, Soo Kun |
author_sort |
Jalalonmuhali, Maisarah |
title |
The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience |
title_short |
The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience |
title_full |
The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience |
title_fullStr |
The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience |
title_full_unstemmed |
The effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: A single tertiary center experience |
title_sort |
effects of different induction regimes on serial lymphocyte subsets in kidney transplant recipients: a single tertiary center experience |
publisher |
Elsevier Science Inc |
publishDate |
2022 |
url |
http://eprints.um.edu.my/42969/ |
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1781704660021673984 |
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13.160551 |