Use of ATG-Fresenius as an Induction Agent in Deceased-Donor Kidney Transplantation.
BACKGROUND
Anti-T-lymphocyte globulins (ATG) are most commonly used as induction agents in kidney transplantation (KT). In this study, we investigated the use of ATG as induction therapy in deceased-donor KT.


METHODS
Among 152 deceased-donor KT recipients transplanted between January 2009 and December 2003, 147 with exact data were enrolled in this study. Delayed graft function was defined as dialysis requirement after KT. Greater than 10% panel-reactive antibody (PRA) was considered as positive. Total ATG (rATG-Fresenius) dosage and induction duration was evaluated. Mean age was 45 ± 10 years; 91 patients were male and 56 patients were female. Class I and class II PRA-positive patient numbers were 20 (13.6%) and 17 (11.5%), respectively. Pre-transplant dialysis vintage was 108 ± 63 months. Mean donor age was 42 ± 17, and cold ischemia time was 16 ± 5 hours. Eighty-nine patients (60%) had delayed graft function and needed at least one session of hemodialysis after transplantation. Cumulative ATG-F dosage was 676 ± 274 mg. The mean ATG-F cumulative dosage was 10.6 ± 3.8 mg/kg. At the end of first year, mean creatinine and proteinuria levels were 1.4 ± 1.0 mg/dL and 0.3 ± 0.4 g/d, respectively.


RESULTS
Mean follow-up time was 32 ± 20 months. During follow-up, there were 14 graft failures and 11 patients died. Patient survival for 1 and 2 years were 93% and 92.3%, respectively. Death-censored graft survival rates for 1 and 2 years were 94.8% and 90.8%, respectively.


CONCLUSIONS
ATG-F induction provides acceptable graft and patient survival in deceased-donor KT. ATG-F infusion is well tolerated. Infection rates seem to be acceptable compared with all transplantation populations.
School of Medicine, Department of Nephrology, Ege University, Izmir, Turkey. Electronic address: mumt@hotmail.com.
M
M
Yilmaz
School of Medicine, Department of General Surgery, Ege University, Izmir, Turkey.
T Ö
TÖ
Sezer
School of Medicine, Department of Internal Medicine, Ege University, Izmir, Turkey.
O
O
Kir
School of Medicine, Department of Internal Medicine, Ege University, Izmir, Turkey.
A
A
Öztürk
School of Medicine, Department of General Surgery, Ege University, Izmir, Turkey.
C
C
Hoşcoşkun
School of Medicine, Department of Nephrology, Ege University, Izmir, Turkey.
H
H
Töz
D000328:Adult; D051799:Delayed Graft Function / Q000188:drug therapy; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged
D007166:Immunosuppressive Agents