title: Five-year follow up of thymoglobulin versus ATGAM induction in adult renal transplantation.
abstract: BACKGROUND
  One-year results of a randomized, double-blinded trial of Thymoglobulin versus Atgam for induction therapy in renal transplantation revealed that Thymoglobulin was associated with higher event-free survival (94% vs. 63%), less acute rejection (4% vs. 25%), and better graft survival. This article compares the safety and efficacy of Thymoglobulin versus Atgam induction through 5 years.
  
  
  METHODS
  Review and analysis of clinic records and electronic databases.
  
  
  RESULTS
  At 5 years, event-free survival (73% vs. 33%, P<0.001), graft survival (77% vs. 55%, P=0.047), and freedom from rejection (92% vs. 66%, P=0.007) were higher with Thymoglobulin versus Atgam. No additional cytomegalovirus (CMV) disease occurred after the first year with Thymoglobulin or Atgam (13% vs. 33%, P=0.056). There were two cases of posttransplant lymphoproliferative disorder (PTLD) with the Atgam arm and none with Thymoglobulin. Thymoglobulin was associated with profound lymphopenia at 2 years after transplantation.
  
  
  CONCLUSIONS
  Thymoglobulin was associated with higher event-free survival, graft survival, and freedom from rejection without increased PTLD or CMV disease at 5 years compared with Atgam. The prolonged and profound lymphopenia may contribute to the long-term results associated with Thymoglobulin.
authors.affiliation: Department of Pharmacy, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Hardinger
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schnitzler
authors.forename: Brent
authors.initials: B
authors.lastname: Miller
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lowell
authors.forename: Surendra
authors.initials: S
authors.lastname: Shenoy
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Koch
authors.forename: Decha
authors.initials: D
authors.lastname: Enkvetchakul
authors.forename: Connie
authors.initials: C
authors.lastname: Ceriotti
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Brennan
mesh_terms: D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology* / Q000401:mortality / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum