Abstract 18653: Outcomes After Induction Immunosuppression in Heart Transplant Patients

• DOI: 10.1161/circ.132.suppl_3.18653
• Publication Date: 2022-03-19T21:52:40Z
• Authors: Vishnu Ambur; Sharven Taghavi; Yuka Furuya; Senthil Jayarajan; Akira Shiose; Eros Leotta; Jesus Gomez-Abraham; Yoshiya Toyoda
• Keywords: Thymoglobulin; Immunosuppression; Basiliximab; Subgroup analysis; Panel reactive antibody

Introduction: Outcomes after induction immunosuppression in heart transplant patients have not been investigated since the allocation policy was changed 2006. The optimal therapy continues to be controversial with many centers continuing use none at all. We evaluated outcomes modern agents primary end points being survival and rejection. Methods: United Network for Organ Sharing (UNOS) database examined all transplants from January 2006 December 2012. Patients receiving were compared those no agent. Additional subgroup analysis performed on group including either basiliximab (Simulect), thymoglobulin, or alemtuzumab (Campath). Kaplan Meier curves multivariate cox regression utilized evaluate outcomes. Results: Of 14,210 during this time period, 5905 (41%) received while 8605 (59%) therapy. Interestingly, had a lower incidence of acute rejection (15.5% vs. 36.8%, p = 0.005). However, revealed difference between two cohorts (6.36 6.23 years; 0.59). On analysis, associated advantage (HR: 0.95; 0.88 - 1.03, 0.23). Subgroup that Campath highest (29.5% 19.3% 9.6%, < 0.0001) panel reactive antibody (7.6 vs 4.3 4.9, 0.002) thymoglobulin lowest. Simulect 1.08; 0.97 1.19, 0.16), 0.87; 0.69 1.09, 0.22), Thymoglobulin 0.94; 0.77 1.14, 0.50) did provide benefit (6.26 5.59 6.26 0.21). Conclusions: This transplantation change shows does affect when induction. Furthermore, there is comparing three most commonly used agents: Simulect, Campath, thymoglobulin.