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Single-Dose Induction with Rabbit Anti-Thymocyte Globulin (rATG; 6 mg/kg over 24 Hours) Is Safer and Improves Immediate and Long-Term Renal Allograft Function
American Journal of Transplantation
  • R. Brian Stevens, Wright State University
  • Theodore H. Rigley
  • Kathleen J. Nielsen
  • Anna J. Skorupa
  • John P. Sandoz
  • Anna M. Kellogg
  • Lucile E. Wrenshall, Wright State University - Main Campus
Document Type
Abstract
Publication Date
5-1-2009
Abstract

We conducted a prospective randomized trial in renal transplant recipients of two 6mg/kg rATG dosing protocols, single vs. 4 divided doses. We present 167 patients (single dose n = 83, divided dose n = 84) after a mean follow-up of 26.7 ± 14.3 months. There were no significant differences in adverse events related to rATG infusion, patient and graft survival, and acute rejection. Estimated glomerular filtration rate (eGFR) on day 4 was significantly higher in the single-dose group than in the divided-dose group (50.0 ± 24.8 vs. 41.2 ± 25.7ml/min/1.73, p = 0.05). Importantly, for the first 24 months post-transplantation single-dose recipients showed significantly better renal function (p = 0.013), with recipients of kidneys from deceased donors showing the greatest benefit (p = 0.0004). The incidence of chronic allograft nephropathy was lower in the single-dose group (p < 0.05). A composite endpoint (cancer, BK nephropathy, death) strongly trended toward worse outcome in the divided-dose group (p = 0.06). Administration of 6mg/kg rATG as a single 24-hour infusion is safer and is associated with better early and long-term renal function than conventional administration in divided doses.

Comments

Abstract #616

Citation Information
R. Brian Stevens, Theodore H. Rigley, Kathleen J. Nielsen, Anna J. Skorupa, et al.. "Single-Dose Induction with Rabbit Anti-Thymocyte Globulin (rATG; 6 mg/kg over 24 Hours) Is Safer and Improves Immediate and Long-Term Renal Allograft Function" American Journal of Transplantation Vol. 9 Iss. s2 (2009) p. 189 - 383 ISSN: 16006135
Available at: http://works.bepress.com/lucile_wrenshall/47/