Antithymocyte Globulin Dosing Effects on Biopsy-Proven Acute Rejection and Infection Risk

Tenney, Justin W; Mokaddem, Samir; Shah, Vaibhav; Adekile, Ayoola

doi:10.12659/aot.892966

Cited by 5 publications

(1 citation statement)

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“…Previous studies demonstrated that allograft rejection in different induction regimens appears to be similar, but higher doses of ATG are thought to be associated with an increased risk of death and infection [14–18]. Our study showed higher rejection episodes in the non-induction group compared to the other groups, but this difference was not statistically significant, and the dosage of ATG did not affect allograft survival.…”

Section: Discussioncontrasting

confidence: 64%

Infectious Complications of Induction Therapies in Kidney Transplantation

et al. 2019

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Background Cytomegalovirus (CMV) and BK virus (BKV) are post-transplant opportunistic viral infections that affect patient and graft survival. This study was designed to evaluate the risk of BKV nephropathy and CMV disease in kidney transplant recipients who received induction therapy with ATG or basiliximab. Material/Methods We retrospectively analyzed information on 257 adult patients who underwent kidney transplantation between January 2007 and 2017. Patients were categorized into 3 groups according to the induction therapies . The primary endpoint was the onset of CMV disease or biopsy-confirmed BKV nephropathy. The secondary endpoints were biopsy-proven rejection episodes, graft loss, loss to follow-up, and death. Results We followed 257 patients for a median of 55.5 months. The incidence of CMV disease was significantly higher in the only ATG group compared to the group without induction treatment (p<0.001). There was no significant difference in the incidence of BKV nephropathy among groups (p>0.05). The dosage of ATG (OR, 10.685; 95% CI, 1.343 5 to 85.009; P=0.025) was independent risk factor for death. Conclusions This study demonstrated that a higher dosage of ATG in high-risk patients is associated with an increased risk of CMV disease and patient death, also, reducing the dosage may be a rational strategy for increasing graft and patient’s survival.

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Section: Discussioncontrasting

confidence: 64%