10.6084/m9.figshare.4558018.v1 Gentile G. Gentile G. Somma C. Somma C. Gennarini A. Gennarini A. Mastroluca D. Mastroluca D. Rota G. Rota G. Lacanna F. Lacanna F. Locatelli B. Locatelli B. Remuzzi G. Remuzzi G. Ruggenenti P. Ruggenenti P. Supplementary Material for: Low-Dose RATG with or without Basiliximab in Renal Transplantation: A Matched-Cohort Observational Study Karger Publishers 2017 Kidney transplantation Graft rejection Induction Basiliximab Thymoglobulin Steroid withdrawal Minimization 2017-01-17 15:22:50 Dataset https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Low-Dose_RATG_with_or_without_Basiliximab_in_Renal_Transplantation_A_Matched-Cohort_Observational_Study/4558018 <p><b><i>Background/Aims:</i></b> In renal transplantation, peri-operative low-dose rabbit-antithymocyte-globulin (RATG) plus basiliximab induction prevented acute allograft rejection more effectively than post-operative RATG plus basiliximab induction. We investigated the specific antirejection contribution of basiliximab in this context. <b><i>Methods:</i></b> This single-center, observational, matched-cohort study evaluated allograft rejections (primary outcome), steroid exposure and side effects, GFR (iohexol plasma clearance) and treatment costs in 16 deceased-donor renal transplant recipients induced with RATG (0.5 mg/kg/day) and 32 age-, gender- and treatment-matched reference-patients given RATG plus basiliximab (20 mg on days 0 and 4). <b><i>Results:</i></b> Induction was well tolerated. At 18 months, 8 patients (50%) vs. 3 reference-patients (9.4%) rejected the graft [HR (95% CI): 6.53 (1.73-24.70), p = 0.006]. Difference was significant (p < 0.01) even after adjusting for recipient/donor age and gender, cold ischemia time and HLA mismatches. There were 1 antibody-mediated rejection and 2 moderate cellular rejections in patients vs. none in reference-patients (p = 0.032). The median (interquartile range) prednisone cumulative dose was remarkably higher in patients than reference-patients [4.78 (1.12-6.10) vs. 0.19 (0.18-3.81) grams, p = 0.002]. Three patients vs. 24 reference-patients were off-steroid at study end (p < 0.001). Three patients vs. no reference-patient developed new-onset diabetes (p = 0.003). Both inductions similarly depleted B-cells. Outcomes of AZA- vs. MMF-treated participants were similar. GFR was similar in all groups. Compared to MMF, AZA therapy saved ≈ EUR 2,500/year and by month 14.3 post-transplant compensated basiliximab costs. <b><i>Conclusion:</i></b> In renal transplantation, basiliximab plus peri-operative low-dose RATG more efficiently prevented allograft rejection than RATG monotherapy, and minimized steroid exposure and toxicity. AZA- vs MMF-based maintenance immunosuppression largely compensated the extra costs of basiliximab.</p>