title: [Safety and efficacy of preoperative induction therapy using a single high dose ATG-F in renal transplantation: a meta-analysis of randomized controlled trials].
abstract: OBJECTIVE
  This study aimed to evaluate the safety and efficacy of preoperative induction therapy using a single high dose (9 mg/kg) of antithymocyte globulin-Fresenius S (ATG-F) for patients undergoing renal transplantation.
  
  
  METHODS
  Randomized controlled clinical trials (RCTs) on the safety and efficacy of preoperative induction therapy using a single high dose of ATG-F for patients undergoing renal transplantation were searched in Cochrane Library, PubMed, EMBASE covering a period from the beginning of databases to July 2015. The meta-analysis was conducted using RevMan 5.2.
  
  
  RESULTS
  Five RCTs with 346 patients were included in this study. The meta-analysis showed that the incidences of acute rejection for the patients with renal transplantation were 20.6% (37/180) in the induction therapy group using a single high dose of ATG and 42.8% (71/166) in the control group, with a combined relative risk (RR) of 0.49 and 95% confidence interval (CI) of[0.36, 0.69](P<0.000 1). The patient survival rate (1 year: RR=1.02, 95% CI[0.98, 1.06], P=0.43; 5 years: RR=1.01, 95% CI[0.94, 1.08], P=0.83) and the graft survival rate (RR=1.04, 95% CI[0.97, 1.12], P=0.24) of the two groups were similar. The incidences of CMV infection, urinary tract infection, and malignant tumor were also similar in the two groups.
  
  
  CONCLUSIONS
  The induction therapy using a single high dose of ATG-F significantly reduced the incidence of acute rejection after transplantation and showed no increased incidence of urinary tract infection, CMV infection, or malignant tumor. The results of our meta-analysis suggest that the application of a high dose of ATG-F may be a safe and effective induction therapy.
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020 China.
authors.forename: H
authors.initials: H
authors.lastname: Yin
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.forename: Q
authors.initials: Q
authors.lastname: Zhang
authors.forename: W R
authors.initials: WR
authors.lastname: Xue
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Zhang
authors.forename: S
authors.initials: S
authors.lastname: Zeng
authors.forename: X P
authors.initials: XP
authors.lastname: Hu
mesh_terms: D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000517:prevention & control; D006084:Graft Rejection / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods* / Q000401:mortality; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000401:mortality; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents