Reduced <scp>ATG</scp>‐F dosage for induction in pediatric renal transplantation: A single‐center experience

Shang, Wenjun; Gao, Feng; Gao, Shilin; Wang, Zhigang; Pang, Xinlu; Liu, Jinfeng; Liu, Lei; Feng, Yue; Xie, Hongsheng; Zhang, Shuijun; Qiao, Baoping

doi:10.1111/petr.12224

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…Chen et al (8) compared the efficacy and safety between rabbit anti-thymocyte globulin and anti-T lymphocyte globulin in renal transplant patients receiving allografts from donors who had suffered cardiac death, and indicated a higher rate of acute rejection (19.4%) but similar 1-year graft (97%) and patient survival (100%) in those receiving ATG-F compared with those determined in the present study. Shang et al (14) indicated that the rate of acute rejection at 12 months was 15.4% but the 1-year patient and graft survival was 94.9% among recipients who received ATG-F 1.5 mg/kg daily for 4 days in combination with a standard triple immunosuppression regimen. In that study, the incidence of post-operative infection was 35.9% (14).…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of anti-T-lymphocyte globulin-Fresenius as an induction agent in deceased-donor renal transplantation: A cohort study

Chai

et al. 2020

Exp Ther Med

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Anti-T-lymphocyte globulin (ATG) is frequently used in the induction regimen of renal transplantation, but its dose has not been standardized. In the present study, the efficacy of different ATG-Fresenius (ATG-F) doses was assessed in recipients of renal transplantation. A total of 131 adult recipients of renal transplantation who received ATG-F induction between August 2015 and July 2018 were included. The incidence of biopsy-confirmed acute rejection, graft function, as well as graft and patient survival within 12 months post-transplant, was assessed, and adverse events, including hematologic and infection-associated side effects, were compared between patients receiving a cumulative ATG-F dose of <7 or ≥7 mg/kg. The incidence of biopsyconfirmed acute rejection was similar between patients receiving cumulative doses of <7 and ≥7 mg/kg (7.5 vs. 4.7%, P=0.766). The incidence of infection within 12 months was lower in the ATG-F <7 mg/kg group compared with that in the ≥7 mg/kg group (26.9 vs. 50.0%, P= 0.006), but the incidence of pneumonia did not differ between the ATG-F <7 and ≥7 mg/kg groups (10.4 vs. 20.3%, P= 0.117). The incidence of urinary infection was higher in the ≥7 mg/kg group than in the <7 mg/kg group (20.4 vs. 7.46%, P= 0.033), while the extent and duration of anemia and lymphopenia was similar between groups. There was no difference in graft function, delayed graft function, as well as overall and graft survival between the groups. In conclusion, a moderate reduction in the cumulative ATG-F dose was not associated with an increased risk of acute rejection, while the risk of infection was reduced. Optimization of the ATG-F dose for induction may facilitate the reduction of the risk of infection without compromising the induction efficacy in renal transplant recipients.

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Section: Discussionmentioning

confidence: 99%

“…Shang et al (14) indicated that the rate of acute rejection at 12 months was 15.4% but the 1-year patient and graft survival was 94.9% among recipients who received ATG-F 1.5 mg/kg daily for 4 days in combination with a standard triple immunosuppression regimen. In that study, the incidence of post-operative infection was 35.9% (14).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of anti-T-lymphocyte globulin-Fresenius as an induction agent in deceased-donor renal transplantation: A cohort study

Chai

et al. 2020

Exp Ther Med

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Kidney Transplantation from Pediatric Donors in a Single Chinese Center

Liu

Jia²,

Guo

et al. 2014

Cell Biochem Biophys

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To report clinical outcomes of kidney transplantation from pediatric brain and cardiac death donors (DBCD) in a single Chinese center and to investigate its feasibility to expand organ donor pool. 18 recipients, transplanted between August 2011 and October 2013 in the First Affiliated Hospital of Zhengzhou University, receive a single graft from DBCD donors age ranged from 1.5 to 13 years old. Renal function expressed as serum creatinine, blood urea nitrogen as well as eGFR values at 1, 2 weeks as well as 1-, 3-, 6-, and 12-months post-transplantation was evaluated. Graft size was also monitored at the same time by ultrasonography. In addition, delayed graft function, acute rejection, surgical complication as well as patient and graft survival were also assessed. The primary causes of DBCD donors included six cases of severe brain trauma and three cases of cerebral hemorrhage. The mean age of DBCD donors was (7.2 ± 3.4) years (range 1.5-13). The mean weight of DBCD donors was (29.8 ± 15.3) kilogram (range 13-67). The mean height of DBCD donors was (118.3 ± 27.8) centimeter (range 70-173). ECMO was applied to DBCD donors to avoid warm ischemia time and the applicating time was (79.8 ± 44.5) (range 32-180) minutes.There were seven males and 11 females recipients. Among which, 16 recipients were pediatrics and two recipients were adults. The mean age of the recipients was (14.6 ± 9.7) years (range 4-47). The mean weight of recipients was (31.9 ± 12.4) kilogram (range 11-54). The mean height of recipients was (138.0 ± 23.7) centimeter (range 84-172). Renal function recovered to normal within the first-week post-operation except one recipient which occurred acute rejection. Two cases of renal artery stenosis were found 2-week and 3-month post-transplantation, respectively. They subsequently underwent ballon angioplasty and followed up for 8 and 12 months, respectively, and no recurrence was found. One recipient developed ureteral leak. Five weeks later, the ureter leak healed after adequate drainage and prolongation of indwelling catheter. Graft size significantly and continuously increased during the first year, especially in the first 3-month post-transplantation. All the 18 recipients are alive at the last follow-up. Among which, 16 recipients are followed up for 12 months and 1-year recipient/graft survival rate is 100 %. The use of single kidney graft from pediatric DBCD could yield good short-term results.

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Kidney Transplantation in Children

Winterberg¹,

Garro²

2019

Kidney Transplantation - Principles and Practice

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Reduced ATG‐F dosage for induction in pediatric renal transplantation: A single‐center experience

Cited by 6 publications

References 16 publications

Efficacy of anti-T-lymphocyte globulin-Fresenius as an induction agent in deceased-donor renal transplantation: A cohort study

Efficacy of anti-T-lymphocyte globulin-Fresenius as an induction agent in deceased-donor renal transplantation: A cohort study

Kidney Transplantation from Pediatric Donors in a Single Chinese Center

Kidney Transplantation in Children

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