Transplant Induction Therapy — ESENeph MCQ

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ModerateTransplantationTransplant Induction TherapyESENeph

A 45-year-old man has a kidney transplant from a donor with 3 HLA mismatches. He is at high immunological risk. According to KDIGO 2009, what induction therapy is recommended for high-risk recipients?

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Correct answer: A — Lymphocyte-depleting agent (e.g. Anti-thymocyte globulin)

KDIGO 2009 recommends that biologics should be used as induction therapy (1A). For patients at high immunological risk (e.g. high PRA, multiple HLA mismatches, prior transplant, DSA), a lymphocyte-depleting agent such as anti-thymocyte globulin (ATG) is preferred over an IL-2 receptor antagonist (Basiliximab). Basiliximab is appropriate for low immunological risk. Alemtuzumab is used at some centres but is not a standard KDIGO recommendation.

Reference: KDIGO 2009 – Transplant Guideline