ArticleTransplant international : official journal of the European Society for Organ Transplantation2018
Center practice drives variation in choice of US kidney transplant induction therapy: a retrospective analysis of contemporary practice.
Article in Transplant international : official journal of the European Society for Organ Transplantation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of T cell-mediated rejection therapy: A systematic review and meta-analysis.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Pooled it
- Hospitalization Costs of Kidney Transplantation Associated With Induction Therapy Among Pediatric Kidney Transplant Recipients: A North American Pediatric Renal Trials and Collaborative Studies and Pediatric Health Information System Collaborative Study.Pediatric transplantation · 2026Article
- Outcomes Following Alemtuzumab Induction in Deceased Donor Kidney Transplantation According to Recipient Age Categories: A Single Center Report.Clinical transplantation · 2026Article
- Induction therapy in kidney transplant recipients: A consensus statement of Indian Society of Organ Transplantation.World journal of transplantation · 2026Review
- Program Report-Transplant Manitoba Adult Kidney Program Cutting Costs, Not Corners: Value of Quality Improvement Initiatives.Canadian journal of kidney health and disease · 2025Article
- Kidney Transplant Outcomes With Non-Depleting Antibody Induction Therapy in Human Leucocyte Antigen Sensitised Recipients.Transplant international : official journal of the European Society for Organ Transplantation · 2025Article
- T-cell receptor sequencing reveals selected donor-reactive CD8American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- Pediatric Kidney Transplantation: Cancer and Cancer Risk.Seminars in nephrology · 2024Review
- Outcomes based on induction regimens in pediatric kidney transplantation: a NAPRTCS and PHIS collaborative study.Pediatric nephrology (Berlin, Germany) · 2023Article
- Baseline Characteristics and Representativeness of Participants in the BEST-Fluids Trial: A Randomized Trial of Balanced Crystalloid Solution Versus Saline in Deceased Donor Kidney Transplantation.Transplantation direct · 2022Article
- Use and Outcomes of Induction Therapy in Well-Matched Kidney Transplant Recipients.Clinical journal of the American Society of Nephrology : CJASN · 2022Article
- Optimal Immunosuppression Strategy in the Sensitized Kidney Transplant Recipient.Journal of clinical medicine · 2021Review
- Clinical Correlates and Outcomes of Dual Basiliximab and Antithymocyte Globulin Induction in Kidney Transplant Recipients: A National Study.Transplantation direct · 2021Article
- Low-Dose Antithymocyte Globulin Has No Disadvantages to Standard Higher Dose in Pediatric Kidney Transplant Recipients: Report From the Pediatric Nephrology Research Consortium.Kidney international reports · 2021Article
- Adequate tacrolimus exposure modulates the impact of HLA class II molecular mismatch: a validation study in an American cohort.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Induction immunosuppression and the risk of incident malignancies among older and younger kidney transplant recipients: A prospective cohort study.Clinical transplantation · 2020Article
- Sensitization in transplantation: Assessment of risk (STAR) 2019 Working Group Meeting Report.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020Review
- KidneyCare Guided Immuno-Optimization in Renal Allografts: The KIRA Protocol.Methods and protocols · 2020Article
- Reassessing Rabbit Antithymocyte Globulin Induction in Kidney Transplantation (RETHINK): An Analysis of the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) Registry.Transplantation direct · 2020Article
- Molecular Mismatch-the Renaissance of HLA in Kidney Transplantation.Journal of the American Society of Nephrology : JASN · 2020Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
To assess factors that influence the choice of induction regimen in contemporary kidney transplantation, we examined center-identified, national transplant registry data for 166 776 US recipients (2005-2014). Bilevel hierarchical models were constructed, wherein use of each regimen was compared pairwise with use of interleukin-2 receptor blocking antibodies (IL2rAb). Overall, 82% of patients received induction, including thymoglobulin (TMG, 46%), IL2rAb (22%), alemtuzumab (ALEM, 13%), and other agents (1%). However, proportions of patients receiving induction varied widely across centers (0-100%). Recipients of living donor transplants and self-pay patients were less likely to receive induction treatment. Clinical factors associated with use of TMG or ALEM (vs. IL2rAb) included age, black race, sensitization, retransplant status, nonstandard deceased donor, and delayed graft function. However, these characteristics explained only 10-33% of observed variation. Based on intraclass correlation analysis, "center effect" explained most of the variation in TMG (58%), ALEM (66%), other (51%), and no induction (58%) use. Median odds ratios generated from case-factor adjusted models (7.66-11.19) also supported large differences in the likelihood of induction choices between centers. The wide variation in induction therapy choice across US transplant centers is not dominantly explained by differences in patient or donor characteristics; rather, it reflects center choice and practice.
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