Predictive Factors of Acute Rejection in Low Immunologic Risk Kidney Transplant Recipients Receiving Basiliximab

Area of Science:

• Nephrology
• Transplantation Immunology

Background:

• Optimal immunosuppression for low-risk kidney transplant recipients remains debated.
• Basiliximab (BSX) offers reduced acute rejection (AR) with a favorable safety profile.

Purpose of the Study:

• Identify predictors of AR in low-risk kidney transplant patients receiving BSX induction therapy.
• Evaluate the impact of panel reactive antibody (PRA) levels on AR incidence.

Main Methods:

• Retrospective analysis of 346 low-immunologic-risk kidney transplant recipients (<50% PRA).
• Patients received BSX, calcineurin inhibitor, mycophenolate mofetil, and prednisolone.
• Logistic regression and ROC curve analysis identified risk factors and optimal PRA cut-offs for AR.

Main Results:

• The overall AR rate was 7.8%.
• Independent risk factors for AR included older age and higher PRA levels.
• PRA >10% was associated with a significantly increased AR incidence (19.2% vs 6.0%).

Conclusions:

• Low-immunologic-risk kidney transplant patients with PRA >10% exhibit higher AR rates.
• Intensified immunosuppressive induction therapy is recommended for these patients.
• Higher PRA levels warrant closer monitoring and tailored immunosuppression strategies.