• Matej Vnucak, Karol Granak, Monika Beliancinova, Igor Gala, Michaela Chrapekova, Andrea Kovacova, Luboslav Bena, Zuzana Zilinska, and Ivana Dedinska.
• Bratisl Med J. 2022 Jan 1; 123 (10): 730-735.

ObjectivesThe aim of the study was to stratify the immunological risk based on the presence of risk factors using different induction immunosuppressive protocols.BackgroundThe path to successful kidney transplantation reflects the accuracy of immunological risk assessment and choice of correct induction and maintenance of immunosuppression to avoid acute kidney rejection.MethodsWe performed a multicentre prospective analysis consisting of patients after kidney transplantation with a 12-month follow-up.ResultsIn total, 152 kidney transplant recipients were included, of whom 100 were males (66.4 %). We divided patients according to the induction immunosuppression as follows: no induction (n = 19), induction with basiliximab (n = 60), and induction with ATG at cumulative doses of 3.5 mg/kg (n = 42) and 6 mg/kg (n = 31). In our study, we demonstrated a shorter survival of patients without induction immunosuppression. In the basiliximab group, the duration of dialysis ≥ 3 years (p = 0.0191), cold ischaemia time ≥ 1,020 minutes or expected delayed graft function (p < 0.0001) are independent risk factors for graft loss (p = 0.0097).ConclusionsRisk of no induction immunosuppression significantly exceeds the risks associated with its administration and is desirable even in patients at low immunological risk. Induction immunosuppression should be tailored individually and thus differ from patient to patient (Tab. 6, Fig. 1, Ref. 15).

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