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Clinical Experience of 6 Years with Rabbit Anti-Thymocyte Globulin as Induction Therapy in Renal Transplant Receptors

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The rabbit-derived anti-thymocyte globulin (rATG/ThymoglobulineÒ) is currently the most commonly used drug in induction therapy regimens in kidney transplantation worldwide. Objective Success rate in the survival of the renal graft… Click to show full abstract

The rabbit-derived anti-thymocyte globulin (rATG/ThymoglobulineÒ) is currently the most commonly used drug in induction therapy regimens in kidney transplantation worldwide. Objective Success rate in the survival of the renal graft and adverse effects at one year with Thymoglobuline as inducer in the immediate post-transplant. Material and Methods In a retrospective cohort of post-transplant kidney patients who received Thymoglobuline as induction, 12 months were followed. We include recipients of a related live donor, unrelated and deceased. We obtained information about accumulated dose, cytopenias, renal function, rejection, adverse effect, modification of maintenance immunosuppression due to leukopenia, lymphoproliferative disorders, bacterial, mycotic and viral infections as well as graft and patient survival. Results We included 165 kidney transplant recipients, 38.7% related live donor, 30.9% unrelated live, 30.3% deceased. The cumulative dose of Thymoglobuline was 5.3 ± 1.61 mg/kg. Absence of rejection 92.72% at 12 months, 7.27% presented rejection and graft loss 0.6% of the population. Serious adverse effects to Thymoglobuline 1.2%. Thrombocytopenia 26.06%, 95.34% grade 1 (114.01 ± 0.20 cells/mm3). Leukopenia 7 days 8.4%, most grade 1 (92.8%) average 3.48 ± 0.28 cells/mm3, at 3 months in 33.93% grade 1 in 50 % 3.60 ± 0.21 cells/mm3, severe 1.78%. No patient had lymphoproliferative disease and 53.93% bacterial infections. Conclusions The use of rATG as post-transplant induction therapy has an excellent success rate with 95.9% patient survival and 95.4% of the graft per year, a lower rejection rate of 7.27%, with few adverse effects and none serious.

Keywords: anti thymocyte; thymocyte globulin; induction therapy; transplant; induction

Journal Title: Transplantation
Year Published: 2018

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