ISSN: 1859 - 2872
Effectiveness and safety of antithymocyte globulins used in induction therapy in kidney transplant recipients in 108 Military Central Hospital
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Abstract
Objective: To describe our experiences with a group of renal transplant patients treated with rabbit antithymocyte globulin (ATG) as induction therapy at transplant to reduce the incidence of acute rejection and prevent delayed allograft function at 108 Military Central Hospital. Subject and method: Retrospective study of 8 kidney recipients of deceased-donor or living-donor kidney transplants received rabbit antithymocyte globulin (rATG) from January 2018 to October 2019. Indications and ATG induction were recommended by the North American Organ Transplant Association. The dosage was 1mg/kg in 5 consecutive days from the date of transplant. Prophylactic immunosuppressive therapy included prograf, cellcept and prednisolon. Clinical characteristics, efficacy and safety of ATG, kidney function, and complications evaluated after transplantation until the present time (October 2019). Result: 8 kidney transplant recipients (6 from living donors, 2 from brain death donors) were treated with ATG. The mean age was 42.9 ± 8.6 years (Male/female: 7/1). 6 patients were on dialysis, 1 patient was on peritoneal dialysis, one ESRD patient was on conservative treatment. The average time for dialysis was 28.3 (2 - 120) months. Causes of renal failure were due to glomerulonephritis (7/8 patients, 87.5%). ABO blood type-incompatible kidney transplantation was on 4 pairs (50%), 5 - 6 HLA mismatches 4 pairs (50%). The median follow-up period was 16.6 (1.6 - 25.5) months. No patients had an acute rejection episode. Currently, all recipients had good allograft function (8 patients, 100%). 1 patient had sepsis caused by E. coli and pneumonia, recovered stable with specific treatment. Other complications were mild and self-recover. Conclusion: Considering the study design limitations, we observed that antithymocyte globulins used in induction therapy in kidney transplant recipients had effectiveness and safety in reducing the incidence of acute rejection and preventing delayed allograft function. Complications of infection had rarely been only seen in 1 patient, recovered after antibiotic therapy.
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References
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