title: Antithymocyte Globulin Induction Therapy in Liver Transplant: Old Drug, New Uses.
abstract: To review the use of rabbit antithymocyte globulin (rATG) induction therapy in liver transplant recipients.
  
  
  
  A MEDLINE literature search (inception to March 2016) was conducted using the search terms rabbit antithymocyte globulin, liver transplantation, and induction References from extracted sources were further searched for any relevant, missed data sources.
  
  
  
  All English-language randomized and observational studies were included.
  
  
  
  A total of 9 studies were included in this review evaluating rATG's use for induction therapy. All studies were single-center analyses. rATG induction is utilized to delay calcineurin inhibitor initiation and to minimize or avoid steroids. Patients receiving rATG induction tended to have improved renal function compared with patients not receiving induction. Overall, rejection rates tended to be lower in recipients administered rATG. Regimens varied in each study, with most recipients receiving 2 to 3 doses of induction therapy.
  
  
  
  rATG induction therapy may lead to improved renal function and lower rejection rates following liver transplant. The use of this medication can help avoid unwanted adverse effects from other immunosuppression agents. Because of the potential benefits with this induction agent, rATG may have a larger role in induction therapy for liver transplant recipients.
authors.affiliation: University of Toledo College of Pharmacy, Toledo, OH, USA sarah.petite@utoledo.edu.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Petite
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Bollinger
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Bijan
authors.initials: B
authors.lastname: Eghtesad
mesh_terms: D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006207:Half-Life; D006736:Horses; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D011817:Rabbits
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents
keywords: clinical pharmacy; immunology; immunosuppression; pharmaceutical care; transplantation