Abstract: Introduction. Our study compares 2 immunosuppressive strategies to reduce tacrolimus
nephrotoxicity and its risk of acute tubular necrosis: delayed introduction of tacrolimus
plus thymoglobulin vs initial tacrolimus plus basiliximab on the results of kidney transplant
(KT) using type-III donation after circulatory death (III-DCD).
Material and methods. We analyzed all the transplants performed using type-III DCD in
our hospital (42 cases). They were distributed in a first stage with delayed tacrolimus (3-4
day) þ thymoglobulin and a second one with initial tacrolimus þ basiliximab, with a followup
of 6 months. The rate of delayed graft function, the evolution of renal function, and the
incidence of rejection were compared.
Results. 28 patients received thymoglobulin with delayed tacrolimus, and 13 patients
received basiliximab and tacrolimus from day 0 (1 excluded). There were no significant
differences in delayed graft function (27% group 1 and 23% group 2) or in rejection
(10.7% and 15.4%), respectively. Serum creatinine at day 3, 7, 14, 30, and 180 showed no
statistically significant differences. The levels of tacrolimus measured at 10, 30, 90, and 180
days after transplantation were similar, except for the first month: 10.10 2.3 in group 1
and 12 1.7 ng/mL in group 2 (P ¼ .007).
Conclusions. Delayed introduction of tacrolimus does not seem to suppose a benefit in
KT using type-III DCD; therefore, the use of thymoglobulin, with its higher
