title: Nineteen years of experience utilizing anti-T-Lymphocyte globulin induction in pediatric kidney transplantation.
abstract: BACKGROUND
  The optimal immunosuppressive therapy in kidney transplantation remains controversial. Since 1990, we included, in our department, anti-T-Lymphocyte globulin Fresenius® (ATG-F) in a sequential immunosuppressive therapy in pediatric recipients of deceased donor kidneys. We analysed retrospectively the complications and long-term outcomes.
  
  
  METHODS
  Ninety eight kidney transplants were performed in 91 children and adolescents between November 1990 and October 2009, using deceased donor source grafts. In 86.8% of the recipients ATG-F was used as antibody induction and in 12.2% of the recipients no ATG-F induction was used.
  
  
  RESULTS
  Overall graft survival rates at 1, 5, 10 and 15 years were 91.8%, 86.1%, 75.9% and 61.9% respectively. In the ATG-F group the graft survival at 1, 5, 10 and 15 years was 93%, 89.1%, 79%, 62.4% and in group without ATG-F it was 83.3%, 66.7%, 55.6% at 1, 5, 10 years respectively (p=0.27). The overall incidence of infection was 1.6/patient in the first year post-transplantation and almost all were of mild or moderate intensity. A papillary thyroid carcinoma was diagnosed in one patient and no lymphoid malignancies were observed during the observational period. All patients were alive at the end of follow-up, except one who died of cardiovascular disease, 7 months after graft loss.
  
  
  CONCLUSIONS
  These results indicate that ATG-F induction in pediatric kidney transplantation using deceased donor kidneys is associated with good graft and patient survival rates, and with low levels of complications.
authors.affiliation: Department of Pediatric Nephrology, Centro Hospitalar do Porto, Porto, Portugal. conceicaocmota@gmail.com
authors.forename: Conceicao
authors.initials: C
authors.lastname: Mota
authors.forename: Lassalete
authors.initials: L
authors.lastname: Martins
authors.forename: Teresa
authors.initials: T
authors.lastname: Costa
authors.forename: Leonidio
authors.initials: L
authors.lastname: Dias
authors.forename: Manuela
authors.initials: M
authors.lastname: Almeida
authors.forename: Josefina
authors.initials: J
authors.lastname: Santos
authors.forename: M Sameiro
authors.initials: MS
authors.lastname: Faria
authors.forename: A Castro
authors.initials: AC
authors.lastname: Henriques
authors.forename: Rui
authors.initials: R
authors.lastname: Almeida
mesh_terms: D000293:Adolescent; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005916:Globulins / Q000627:therapeutic use*; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum; D005916:Globulins; D007166:Immunosuppressive Agents