title: Clinical and economic analysis of short-course versus standard-course antithymocyte globulin (rabbit) induction therapy in deceased-donor renal transplant recipients.
abstract: OBJECTIVE
  The immunosuppressive effects of and costs associated with short-course antithymocyte globulin rabbit (ATG [rabbit]) therapy versus standard-course ATG (rabbit) therapy in deceased-donor renal transplant recipients were evaluated.
  
  
  METHODS
  The records of 84 consecutive patients who received a deceased-donor renal transplant at the Montefiore Einstein Center for Transplantation in 2008 were retrospectively reviewed. Donor and recipient characteristics, including rates of biopsy-confirmed acute rejection, serum creatinine (SCr) levels, and frequency of complications, and drug costs were collected. Patients were excluded if they had donor-specific antibodies identified before transplantation or hepatitis-C-positive serology or were under 18 years of age.
  
  
  RESULTS
  A total of 60 patients were included in the study, with 28 receiving short-course ATG (rabbit) therapy and 32 receiving standard-course ATG (rabbit) therapy. Baseline patient demographic characteristics were similar between groups. Six months after transplantation, biopsy-confirmed acute rejection episodes did not significantly differ between the short-course ATG (rabbit) and standard-course ATG (rabbit) groups (17.8% versus 12.5%, respectively), nor did SCr concentrations (1.56 mg/dL versus 1.85 mg/dL). The frequency of therapy-related leukopenia was greater in patients receiving standard-course ATG (rabbit). Patients treated with short-course ATG (rabbit) received a total mean dose of 4.6 mg/kg, compared with 7.3 mg/kg for patients in the standard-course ATG (rabbit) group, resulting in a mean cost saving of $2548 per patient.
  
  
  CONCLUSIONS
  After six months, there were no significant differences in biopsy- confirmed acute rejection episodes or SCr levels between deceased-donor renal transplant recipients receiving short-course versus standard-course ATG (rabbit) induction therapy. The mean cost saving associated with short-course therapy was $2548 per patient.
authors.affiliation: Department of Pharmacy, Montefiore Medical Center, Bronx, NY 10467, USA. kmarfo@montefiore.org
authors.forename: Kwaku
authors.initials: K
authors.lastname: Marfo
authors.forename: Enver
authors.initials: E
authors.lastname: Akalin
authors.forename: Cuiling
authors.initials: C
authors.lastname: Wang
authors.forename: Amy
authors.initials: A
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001706:Biopsy; D017046:Cost Savings; D003404:Creatinine / Q000097:blood; D004334:Drug Administration Schedule; D016527:Drug Costs; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D003404:Creatinine