Evaluating the efficacy of basiliximab versus no induction in low-immunological-risk kidney transplant recipients: a propensity score matched analysis

Background The optimal use of induction therapy in low-immunological-risk kidney transplant recipients (KTRs) remains uncertain. While Basiliximab (BSX) is widely utilized, its comparative outcomes with no induction therapy require further evaluation.Method This single-center retrospective cohort st...

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Main Authors: Dahao Zhang, Jiqiu Wen, Jianhui Dong, Rong Ma, Shijian Li, Jihua Wu, Ning Wen, Zhiying Lei, Haibin Li, Jun Yin, Xuyong Sun
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2460729
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author Dahao Zhang
Jiqiu Wen
Jianhui Dong
Rong Ma
Shijian Li
Jihua Wu
Ning Wen
Zhiying Lei
Haibin Li
Jun Yin
Xuyong Sun
author_facet Dahao Zhang
Jiqiu Wen
Jianhui Dong
Rong Ma
Shijian Li
Jihua Wu
Ning Wen
Zhiying Lei
Haibin Li
Jun Yin
Xuyong Sun
author_sort Dahao Zhang
collection DOAJ
description Background The optimal use of induction therapy in low-immunological-risk kidney transplant recipients (KTRs) remains uncertain. While Basiliximab (BSX) is widely utilized, its comparative outcomes with no induction therapy require further evaluation.Method This single-center retrospective cohort study included 182 low-immunological-risk KTRs who underwent transplantation between January 2022 and March 2023. Patients were assigned to either no induction (n = 41) or BSX induction (n = 141) groups. Propensity score matching (PSM) minimized selection bias and controlled for confounding factors. Primary outcomes included the incidence of first acute rejection (AR) within 12 months, while secondary outcomes encompassed graft function, infection rates, and adverse events.Result After 12 months, the cumulative AR incidence was comparable between groups (p = 0.46). The no induction group demonstrated superior renal function, with consistently higher estimated glomerular filtration rates (eGFR) at early postoperative intervals. Additionally, this group exhibited reduced infection-related hospitalizations (respiratory infections: 7.32 vs. 29.1%, p = 0.008) and hematological complications (thrombocytopenia: 0.00% vs. 12.8%, p = 0.014). Mortality and graft loss rates were similar between groups.Conclusion In low-immunological-risk KTRs, no induction therapy achieves comparable AR prevention and renal function outcomes to BSX while reducing infection and hematological complications. These findings challenge the necessity of universal induction therapy in this population and support a personalized approach to immunosuppression protocols.
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spelling doaj-art-b0f7fbebb3f14f05b5f702b2996377c82025-08-20T02:38:19ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2460729Evaluating the efficacy of basiliximab versus no induction in low-immunological-risk kidney transplant recipients: a propensity score matched analysisDahao Zhang0Jiqiu Wen1Jianhui Dong2Rong Ma3Shijian Li4Jihua Wu5Ning Wen6Zhiying Lei7Haibin Li8Jun Yin9Xuyong Sun10Institute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaInstitute of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Organ Transplantation, Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, ChinaBackground The optimal use of induction therapy in low-immunological-risk kidney transplant recipients (KTRs) remains uncertain. While Basiliximab (BSX) is widely utilized, its comparative outcomes with no induction therapy require further evaluation.Method This single-center retrospective cohort study included 182 low-immunological-risk KTRs who underwent transplantation between January 2022 and March 2023. Patients were assigned to either no induction (n = 41) or BSX induction (n = 141) groups. Propensity score matching (PSM) minimized selection bias and controlled for confounding factors. Primary outcomes included the incidence of first acute rejection (AR) within 12 months, while secondary outcomes encompassed graft function, infection rates, and adverse events.Result After 12 months, the cumulative AR incidence was comparable between groups (p = 0.46). The no induction group demonstrated superior renal function, with consistently higher estimated glomerular filtration rates (eGFR) at early postoperative intervals. Additionally, this group exhibited reduced infection-related hospitalizations (respiratory infections: 7.32 vs. 29.1%, p = 0.008) and hematological complications (thrombocytopenia: 0.00% vs. 12.8%, p = 0.014). Mortality and graft loss rates were similar between groups.Conclusion In low-immunological-risk KTRs, no induction therapy achieves comparable AR prevention and renal function outcomes to BSX while reducing infection and hematological complications. These findings challenge the necessity of universal induction therapy in this population and support a personalized approach to immunosuppression protocols.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2460729Kidney transplantationinduction therapyno inductionlow-immunological-riskinfectionpropensity score matching
spellingShingle Dahao Zhang
Jiqiu Wen
Jianhui Dong
Rong Ma
Shijian Li
Jihua Wu
Ning Wen
Zhiying Lei
Haibin Li
Jun Yin
Xuyong Sun
Evaluating the efficacy of basiliximab versus no induction in low-immunological-risk kidney transplant recipients: a propensity score matched analysis
Renal Failure
Kidney transplantation
induction therapy
no induction
low-immunological-risk
infection
propensity score matching
title Evaluating the efficacy of basiliximab versus no induction in low-immunological-risk kidney transplant recipients: a propensity score matched analysis
title_full Evaluating the efficacy of basiliximab versus no induction in low-immunological-risk kidney transplant recipients: a propensity score matched analysis
title_fullStr Evaluating the efficacy of basiliximab versus no induction in low-immunological-risk kidney transplant recipients: a propensity score matched analysis
title_full_unstemmed Evaluating the efficacy of basiliximab versus no induction in low-immunological-risk kidney transplant recipients: a propensity score matched analysis
title_short Evaluating the efficacy of basiliximab versus no induction in low-immunological-risk kidney transplant recipients: a propensity score matched analysis
title_sort evaluating the efficacy of basiliximab versus no induction in low immunological risk kidney transplant recipients a propensity score matched analysis
topic Kidney transplantation
induction therapy
no induction
low-immunological-risk
infection
propensity score matching
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2460729
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