title: Short-term outcomes of Thymoglobulin induction in pediatric renal transplant recipients.
abstract: No data are currently available that describe the clinical outcomes associated with Thymoglobulin (rabbit polyclonal anti-thymocyte globulin) induction in pediatric renal transplant recipients. We report the outcomes of 17 pediatric renal transplant recipients (mean age 10.1+/-5.2 years) transplanted between 1 August 1999 and 31 July 2001. Eleven patients (65%) were Caucasian and 6 (35%) were African-American. Eleven (65%) recipients received cadaveric allografts. Two patients (12%) were second allograft recipients. One patient had primary allograft non-function secondary to vascular thrombosis. Two patients (12%) had delayed allograft function. Immunosuppression consisted of Thymoglobulin induction (mean number of doses 6+/-1.7) with tacrolimus (62%) or cyclosporine A (38%), mycophenolate mofetil, and prednisone. One year post transplant, patient and graft survival was 100% and 93%, respectively. No acute rejection episodes occurred during the first 6 months after transplantation in any of the recipients. Additionally, no rejection episode occurred among the 14 patients followed for 1 year after transplant. The incidences of asymptomatic cytomegalovirus (CMV) and Epstein-Barr virus (EBV) seroconversion at 1 year in seronegative recipients with a seropositive donor were 100% of 4 patients and 0% of 4 patients, respectively. No symptomatic CMV or EBV infections and no post-transplant lymphoproliferative disease have occurred in any patient. These short-term data suggest that Thymogobulin induction is safe and effective in combination with triple immunosuppressive therapy for preventing early rejection in pediatric renal transplant recipients.
authors.affiliation: Children's Foundation Research Center at the Le Bonheur Children's Medical Center, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA. bault@utmem.edu
authors.forename: Bettina H
authors.initials: BH
authors.lastname: Ault
authors.forename: Marsha R
authors.initials: MR
authors.lastname: Honaker
authors.forename: A
authors.initials: A
authors.lastname: Osama Gaber
authors.forename: Deborah P
authors.initials: DP
authors.lastname: Jones
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Duhart
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Powell
authors.forename: Dena W
authors.initials: DW
authors.lastname: Hays
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wyatt
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000493:pharmacokinetics / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011817:Rabbits; D016559:Tacrolimus / Q000493:pharmacokinetics / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus