Induction therapy in lung transplantation: A contemporary analysis of trends and outcomes

Larisa Shagabayeva, Asishana A. Osho, Philicia Moonsamy, Navyatha Mohan, Selena Shi Yao Li, Stanley Wolfe, Nathaniel B. Langer, Masaki Funamoto, Mauricio A. Villavicencio

Research output: Contribution to journalArticlepeer-review


Objectives: We provide a contemporary consideration of long-term outcomes and trends of induction therapy use following lung transplantation in the United States. Methods: We reviewed the United Network for Organ Sharing registry from 2006 to 2018 for first-time, adult, lung-only transplant recipients. Long-term survival was compared between induction classes (Interleukin-2 inhibitors, monoclonal or polyclonal cell-depleting agents, and no induction therapy). A 1:1 propensity score match was performed, pairing patients who received basiliximab with similar risk recipients who did not receive induction therapy. Outcomes in matched populations were compared using Cox, Kaplan-Meier and Logistic regression modeling. Measurements and main results: 22 025 recipients were identified; 8003 (36.34%) were treated with no induction therapy, 11 045 (50.15%) with basiliximab, 1556 (7.06%) with alemtuzumab and 1421 (6.45%) with anti-thymocyte globulin. Compared with those who received no induction, patients receiving basiliximab, alemtuzumab or anti-thymocyte globulin were found on multivariable Cox-regression analyses to have lower long-term mortality (all p <.05). Following propensity score matching of basiliximab and no induction populations, analyses demonstrated a statistically significant association between basiliximab use and long- term survival (p <.001). Basiliximab was also associated with a lower risk of acute rejection (p <.001) and renal failure (p =.002). Conclusion: Induction therapy for lung transplant recipients—specifically basiliximab—is associated with improved long-term survival and a lower risk of renal failure or acute rejection.

Original languageEnglish
Article numbere14782
JournalClinical Transplantation
Issue number11
StatePublished - Nov 2022


  • graft survival
  • immunosuppressive regimens
  • induction
  • lung (allograft) function/dysfunction


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