Advantage of antithymocyte globulin induction in sensitized kidney recipients: a randomized prospective study comparing induction with and without antithymocyte globulin

Thibaudin, Damien; Alamartine, Éric; Filippis, J.P. de; Diab, Nabil; Laurent, B.; Berthoux, F

doi:10.1093/ndt/13.3.711

Cited by 83 publications

(27 citation statements)

References 2 publications

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“…48 In practice, ATG should be preferred in sensitized patients without DSAs, because two randomized clinical trials showed beneficial short-term effects on acute rejection, graft function, and survival (however, the relationship between induction immunosuppression, dnDSAs, and AMR was not specifically addressed). 49,50 In a more recent trial, Brokhof et al 51 reported in a cohort of 114 moderately sensitized recipients of deceased donor renal transplants that induction with ATG is associated with a reduction in the occurrence of dnDSAs and AMR compared with basiliximab. However, it should be noted that, in this study, (1) the difference became statistically different only at 3 years, (2) only a few patients assigned to basiliximab had a follow-up at 36 months, and (3) the patients who received ATG also received more plasmapheresis and IVIg than the patients who received rituximab.…”

Section: Effect Of Induction Therapy On Dndsa Generationmentioning

confidence: 99%

Effect of Immunosuppressive Drugs on Humoral Allosensitization after Kidney Transplant

Thaunat

Koenig

Leibler³

et al. 2016

JASN

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The negative effect of donor-specific antibodies on the success of solid transplant is now clearly established. However, the lack of effective treatment to prevent the development of antibody-mediated lesions deepens the need for clinicians to focus on primary prevention of de novo humoral allosensitization. Among the factors associated with the risk of developing de novo donor-specific antibodies, therapeutic immunosuppression is the most obvious parameter in which improvement is possible. Beyond compliance and the overall depth of immunosuppression, it is likely that the nature of the drugs is also crucial. Here, we provide an overview of the molecular effect of the various immunosuppressive drugs on B cell biology. Clinical data related to the effect of these drugs on de novo humoral allosensitization are also examined, providing a platform from which clinicians can optimize immunosuppression for prevention of de novo donor-specific antibody generation at the individual level.

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Section: Effect Of Induction Therapy On Dndsa Generationmentioning

confidence: 99%

Effect of Immunosuppressive Drugs on Humoral Allosensitization after Kidney Transplant

Thaunat

Koenig

Leibler³

et al. 2016

JASN

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“…Clinical trials have revealed that induction immunosuppression using antibody therapy decreases the risk of acute rejection for isolated kidney transplants (13,14). Induction therapy may also reduce exposure to calcineurin inhibitors in the peri-transplant period (15,16).…”

Section: Introductionmentioning

confidence: 99%

The Influence of Induction Therapy for Kidney Transplantation after a Non-Renal Transplant

Cassuto¹,

Levine²,

Reese

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Non-renal transplant recipients who subsequently develop ESRD and undergo kidney transplantation are medically and immunologically complex due to comorbidities, high cumulative exposure to immunosuppressants, and sensitization to alloantigen from the prior transplant. Although prior non-renal transplant recipients are one of the fastest growing segments of the kidney wait list, minimal data exist to guide the use of antibody induction therapy (IT+) at the time of kidney after lung (KALu), heart (KAH), and liver (KALi) transplant.Design, setting, participants, & measurements This retrospective cohort study used national registry data to examine IT use and survival after kidney transplantation. Separate multivariate Cox regression models were constructed to assess patient survival for IT+ and IT2 KALu (n=232), KAH (n=588), and KALi (n=736) recipients.

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“…This advantage was also seen among highly sensitized and 'high risk' recipients, making ATG the induction therapy of choice in such patients [36,37]. Therefore, considering the adverse effect profi le of ATG, it is mostly reserved for transplants categorized as 'high risk' of early rejection [5].…”

Section: Causes Actual Lysis Of T Cells and Their Destructionmentioning

confidence: 99%

Tailor-Made Induction Therapy in ‘Low Risk’ Renal Transplants; A South Asian Perspective

Gunawansa¹

2017

Arch Clin Nephrol

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Advantage of antithymocyte globulin induction in sensitized kidney recipients: a randomized prospective study comparing induction with and without antithymocyte globulin

Abstract: We conclude that ATG induction is beneficial for all sensitized patients, regardless of their level of sensitization, with regard to acute rejection episodes, graft survival and graft function. Low-dose ATG is sufficient and prevents additional complications.

Cited by 83 publications

References 2 publications

Effect of Immunosuppressive Drugs on Humoral Allosensitization after Kidney Transplant

Effect of Immunosuppressive Drugs on Humoral Allosensitization after Kidney Transplant

The Influence of Induction Therapy for Kidney Transplantation after a Non-Renal Transplant

Tailor-Made Induction Therapy in ‘Low Risk’ Renal Transplants; A South Asian Perspective

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