Anti-IL-2R blockers comparing with polyclonal antibodies: Higher risk of rejection without negative mid-term outcomes after ABO-incompatible kidney transplantation

Clin Transplant. 2019 Oct;33(10):e13681. doi: 10.1111/ctr.13681. Epub 2019 Sep 8.


There is no recommendation regarding the type of induction therapy to use in ABO-incompatible (ABOi) kidney transplantation. The aim of this retrospective study was to compare the outcome of ABOi living donor kidney transplant (LDKT) recipients who received either polyclonal antibodies or anti-interleukin-2 receptor (IL-2R) blockers as an induction agent. All ABOi HLA-compatible patients that received a LDKT between 03/11 and 03/18 in three French transplantation center (Paris Saint-Louis, Paris Necker, and Toulouse) were included in the study. Fifty-eight patients were given polyclonal antibodies and 39 patients received anti-IL-2R blockers. We identified by a Cox proportional hazard model the use of polyclonal antibodies as a protective factor against acute rejection (HR = 0.4, 95%CI [0-0.9], P < .05). However, pathological findings on protocol biopsies at 1 year were similar in both groups, as were patient and graft survivals, renal function, and complications. We conclude that the acute rejection rate was significantly higher in patients given anti-IL-2R blockers compared to polyclonal antibodies. However, in our series, there was no negative impact on mid-term outcome.

Keywords: ABO incompatibility; immunoadsorption; kidney transplantation; living donor; rejection.

MeSH terms

  • ABO Blood-Group System / immunology*
  • Adult
  • Aged
  • Antibodies / administration & dosage*
  • Antibodies / immunology
  • Blood Group Incompatibility / immunology
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Rejection / diagnosis*
  • Graft Rejection / etiology
  • Graft Rejection / pathology
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / immunology*
  • Kidney Failure, Chronic / surgery
  • Kidney Function Tests
  • Kidney Transplantation / adverse effects*
  • Living Donors / supply & distribution
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Prognosis
  • Receptors, Interleukin-2 / antagonists & inhibitors*
  • Receptors, Interleukin-2 / immunology
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Young Adult


  • ABO Blood-Group System
  • Antibodies
  • Receptors, Interleukin-2