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

Chai,Yun-Xia; Ji,Jian-Lei; Li,Shu-Juan; Cao,Yan-Wei; Sun,Xiao-Xia; Wang,Qing-Hai; Huang,Tao; Dong,Zhen; Wang,Hong-Yang

doi:10.3892/etm.2020.8451

March-2020 Volume 19 Issue 3

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March-2020 Volume 19 Issue 3

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Article

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

Authors:
- Yun-Xia Chai
- Jian-Lei Ji
- Shu-Juan Li
- Yan-Wei Cao
- Xiao-Xia Sun
- Qing-Hai Wang
- Tao Huang
- Zhen Dong
- Hong-Yang Wang
View Affiliations / Copyright

Affiliations: Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
Pages: 2384-2390
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Published online on: January 15, 2020

https://doi.org/10.3892/etm.2020.8451
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Abstract

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 biopsy-confirmed 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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1	Yilmaz M, Sezer TO, Kir O, Öztürk A, Hoşcoşkun C and Töz H: Use of ATG-fresenius as an induction agent in deceased-donor kidney transplantation. Transplant Proc. 49:486–489. 2017. View Article : Google Scholar : PubMed/NCBI
2	Pennington CA, Tischer SM, Lee E, Lee S, Sindelar J Jr and Park JM: Evaluation of a weight-based rabbit anti-thymocyte globulin induction dosing regimen for kidney transplant recipients. Pharmacotherapy. 35:748–754. 2015. View Article : Google Scholar : PubMed/NCBI
3	Beiras-Fernandez A, Thein E and Hammer C: Induction of immunosuppression with polyclonal antithymocyte globulins: An overview. Exp Clin Transplant. 1:79–84. 2003.PubMed/NCBI
4	Morton RL, Howard K, Webster AC, Wong G and Craig JC: The cost-effectiveness of induction immunosuppression in kidney transplantation. Nephrol Dial Transplant. 24:2258–2269. 2009. View Article : Google Scholar : PubMed/NCBI
5	Kaden J, Strobelt V and May G: Short and long-term results after pretransplant high-dose single ATG-fresenius bolus in cadaveric kidney transplantation. Transplant Proc. 30:4011–4014. 1998. View Article : Google Scholar : PubMed/NCBI
6	Kaden J, Völp A and Wesslau C: High graft protection and low incidences of infections, malignancies and other adverse effects with intra-operative high dose ATG-induction: A single centre cohort study of 760 cases. Ann Transplant. 18:9–22. 2013. View Article : Google Scholar : PubMed/NCBI
7	Meier-Kriesche HU, Arndorfer JA and Kaplan B: Association of antibody induction with short- and long-term cause-specific mortality in renal transplant recipients. J Am Soc Nephrol. 13:769–772. 2002.PubMed/NCBI
8	Chen GD, Lai XQ, Ko DS, Qiu J, Wang CX, Han M, Li J, Huang G, He XS and Chen LZ: Comparison of efficacy and safety between rabbit anti-thymocyte globulin and anti-T lymphocyte globulin in kidney transplantation from donation after cardiac death: A retrospective cohort study. Nephrology (Carlton). 20:539–543. 2015. View Article : Google Scholar : PubMed/NCBI
9	Solez K, Colvin RB, Racusen LC, Haas M, Sis B, Mengel M, Halloran PF, Baldwin W, Banfi G, Collins AB, et al: Banff 07 classification of renal allograft pathology: Updates and future directions. Am J Transplant. 8:753–760. 2008. View Article : Google Scholar : PubMed/NCBI
10	Kaden J, May G, Müller P, Groth J, Strobelt V, Eger E and Wohlfahrt L: Intraoperative high-dose anti-T-lymphocyte globulin bolus in addition to triple-drug therapy improves kidney graft survival. Transplant Proc. 27:1060–1061. 1995.PubMed/NCBI
11	Kaden J, May G, Strobelt V, Groth J and Müller P: Intraoperative T-cell depletion prior to completion of anastomoses by high-dose single ATG bolus as a new approach to improve long-term results after kidney transplantation. Transplant Proc. 29:344–347. 1997. View Article : Google Scholar : PubMed/NCBI
12	Yussim A and Shapira Z: Single-bolus high-dose ATG for prophylaxis of rejection in renal transplantation - a prospective, randomized study. Transpl Int. 13 (Suppl 1):S293–S294. 2000. View Article : Google Scholar : PubMed/NCBI
13	Samsel R, Pliszczyński J, Chmura A, Korczak G, Włodarczyk Z, Cieciura T, Lagiewska B, Glyda M, Wyzgal J, Paczek L, et al: Safety and efficacy of high dose ATG bolus administration on rewascularization in kidney graft patients - long term results. Ann Transplant. 13:32–39. 2008.PubMed/NCBI
14	Shang W, Feng G, Gao S, Wang Z, Pang X, Li J, Liu L, Feng Y, Xie H, Zhang S, et al: Reduced ATG-F dosage for induction in pediatric renal transplantation: A single-center experience. Pediatr Transplant. 18:240–245. 2014. View Article : Google Scholar : PubMed/NCBI
15	Brennan DC, Daller JA, Lake KD, Cibrik D and Del Castillo D; Thymoglobulin Induction Study Group, : Rabbit antithymocyte globulin versus basiliximab in renal transplantation. N Engl J Med. 355:1967–1977. 2006. View Article : Google Scholar : PubMed/NCBI
16	Beiras-Fernandez A, Chappell D, Hammer C, Beiras A, Reichart B and Thein E: Impact of polyclonal anti-thymocyte globulins on the expression of adhesion and inflammation molecules after ischemia-reperfusion injury. Transpl Immunol. 20:224–228. 2009. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

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

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