Effect of ATG prophylaxis in sensitized and non-sensitized kidney graft recipients.
In our effort to find an optimum immunosuppressive protocol for kidney transplantation we introduced two forms of ATG prophylaxis: 1. high-dose single-bolus prophylaxis (9 mg/kg) in non-sensitized patients (PRA < 5%); and 2. low-dose 8-day prophylaxis (1.5-3.0 mg/kg) in sensitized patients (PRA > 5%). A total of 204 kidney graft recipients were included in this study and treated with a triple-drug therapy (TDT). In comparison with TDT-treated controls, in sensitized patients the 8-day ATG prophylaxis resulted in a reduced rate of rejection episodes (25.5% vs 47%), an improved 1-year graft survival (82% vs 71%) and patient survival (94% vs 90%). In non-sensitized patients the high-dose single-bolus ATG prophylaxis induced a T-cell lymphopenia lasting 4 to 5 days and, in comparison with the corresponding controls, resulted in a shortened hospital stay (31.2 days vs 36.7 days), a reduced rate of rejection episodes (25.5% vs 53%), an improved 1-year graft survival (92% vs 86%) and patient survival (100% vs 94%).
Kaden
J
J
Department of Immunology, Clinic of Urology, Friedrichshain Hospital, Berlin, FRG.
May
G
G
Schönemann
C
C
Müller
P
P
Groth
J
J
Seeger
W
W
Seibt
F
F
Henkert
M
M
Lippert
J
J
D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007114:Immunization; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D007902:Length of Stay; D018655:Lymphocyte Count; D008991:Monitoring, Physiologic / Q000379:methods; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D013601:T-Lymphocytes / Q000276:immunology
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents