#5509 LOW DOSE THYMOGLOBULIN-BASILIXIMAB INDUCTION PROTOCOL ON INCIDENCE OF ACUTE REJECTION AND POSTTRANSPLANT NEOPLASIA: AN OBSERVATIONAL RETROSPECTIVE STUDY

Abstract Background and Aims Induction therapy plays a key role in the prevention of 1-year acute rejection kidney transplantation. Several studies suggest that depleting drugs, including thymoglobulin (ATG), are superior to anti-CD25 antibodies reducing incidence rejection. However, large retrospective investigations demonstrate close significant association between use agents development post-transplant neoplasia, particular lymphoproliferative disease. Thus, attempt improve risk/benefit profile antibody therapy, we implemented an induction protocol based on low-dose ATG blocker basiliximab (Bas). The aim present study was evaluate efficacy safety this approach compared standard dose alone alone. Method This is observational, retrospective, single center 957 patients receiving transplant Gemelli from January 2000 February 2022 primary outcome biopsy proven neoplasia. Patients group received cumulative 7mg/kg first week after transplantation; Bas were administered at 20 mg before surgery 4 days Finally, ATG-Bas concentration 3mg/kg over 6 transplantation Results In our population evaluated 154 group, 492 low AATG-Bas 311 group. No statistical difference for age, mismatches, donor type, pre-transplant PRA observed among groups. Use mTOR inhibitors more frequent groups (80/154, 155/492, 76/311, respectively, p<0.001). We did not observe any other maintenance immunosuppressive drugs. Multivariate analysis (Cox model, number presence DSA inhibitors) demonstrated only treatment (HR 0.509 95%CI 0.344-0.754, p<0.001), but 0,819 0.472-1.423, p = 0.5), able reduce risk On hand, multivariate model rejection, 1.677 1.035-2.717, 0.03), 1,324 0,930-1,884, 0.1), significantly increased neoplasia Conclusion most effective preventing biopsy-proven addition, contrary it increase therapy.