Thymoglobulin induction is safe and effective in live-donor renal transplantation: a single center experience.
BACKGROUND
The relative benefit versus safety of induction therapy in live-donor renal transplant recipients is controversial. This paper presents observational data of live-donor recipients who received Thymoglobulin induction and standard maintenance immunosuppressive therapy.


METHODS
Review and analysis of clinic records and electronic databases of live-donor renal transplants that received Thymoglobulin induction from May 1996 through 2003.


RESULTS
Data analysis included 214 live-donor recipients (146 related, 68 unrelated) with a mean follow-up of 3.0+/-1.9 years. The average age of recipients was 44+/-13 years, with a majority being Caucasian (86%) and male (64%). Nineteen (9%) received previous transplants. No patients experienced delayed graft function and 10 (5%) developed acute rejection. Overall, predicted five-year patient survival was 96% and graft survival was 82%. The rates of CMV infection (5%), malignancy (3%), and lymphoproliferative disorder (0.5%) were low. When compared to live-donor kidney transplant recipients nationwide, the center cohort demonstrated improved five year patient (96% center versus 90% national, P=0.0326) and graft survival (82% center versus 79% national, P=0.0901), and a lower one-year acute rejection rate (2% center versus 21 % national, P<0.001).


CONCLUSIONS
In this analysis, the use of Thymoglobulin in live-donor renal transplantation was associated with an absence of delayed graft function, low acute rejection rates, and high patient and graft survival without increasing the risk of infection or lymphoproliferative disorder.
Hardinger
Karen L
KL
Department of Pharmacy Practice, University of Missouri-Kansas City, Kansas City, MO 64108-2792, and Department of Medicine, Barnes-Jewish Hospital at Washington University School of Medicine, St. Louis, MO, USA. hardingerk@umkc.edu
Schnitzler
Mark A
MA
Koch
Matthew J
MJ
Labile
Emily
E
Stirnemann
Paula M
PM
Miller
Brent
B
Enkvetchakul
Decha
D
Brennan
Daniel C
DC
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002423:Cause of Death; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D016019:Survival Analysis; D013954:Thyroglobulin / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
D000998:Antiviral Agents; D013954:Thyroglobulin