Tailored Rabbit Antithymocyte Globulin Induction Dosing for Kidney Transplantation

Transplantation Direct
Namita SinghJohn P Vella

Abstract

Rabbit antithymocyte globulin (rATG) is the most widely used kidney transplant induction immunotherapy in the United States. It was recently Food and Drug Administration approved for this indication with typical dose recommendations of 1.5 mg/kg for up to 7 days given via a central line. We theorized that reduced rATG dosing when compared with conventional dosing (6-10.5 mg/kg) is safe and effective, leading to development of a risk-stratified treatment protocol. Five-year data from a retrospective cohort of 224 adult kidney transplants (2008-2013) with follow-up through 2015 is presented. Cumulative rATG doses of 3 mg/kg were administered peripherally to nonsensitized living donor recipients, 4.5 mg/kg to nonsensitized deceased donor recipients. A subset of higher immunologic risk recipients (defined as history of prior transplant, panel reactive antibody greater than 20%, or flow cytometry crossmatch positivity) received 6 mg/kg. There were no differences in patient or graft survival between the 3 groups. One-year rejection rates in the first 2 groups were 8.3% and 8.8%, respectively, comparable to contemporaneous rates reported to the Scientific Registry of Transplant Recipients. Dose tailoring permitted substantial cost sav...Continue Reading

References

May 20, 1971·The New England Journal of Medicine·J A MannickD C Nabseth
Jul 17, 2004·Transplantation·Karen L HardingerDaniel C Brennan
Nov 10, 2006·The New England Journal of Medicine·Daniel C BrennanUNKNOWN Thymoglobulin Induction Study Group
May 24, 2008·Transplantation·Cheryle Gurk-TurnerAbdolreza Haririan
Nov 16, 2010·Journal of Transplantation·Karen L HardingerDaniel C Brennan
Aug 2, 2012·Transplantation·A Osama GaberUNKNOWN Thymoglobulin Antibody Immunosuppression in Living Donor Recipients Investigators
Jan 3, 2013·Transplant International : Official Journal of the European Society for Organ Transplantation·Karen L HardingerChristina L Klein
Jun 19, 2013·American Journal of Nephrology·Umasankar Mathuram ThiyagarajanAtul Bagul
Jun 27, 2015·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Rajiv SaranKevin C Abbott
Dec 24, 2015·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R B StevensA Osama Gaber

❮ Previous
Next ❯

Citations

Dec 7, 2019·Immunological Reviews·Christina R HartiganMandy L Ford
Mar 19, 2021·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Rachel J BubikHeather P May
Jul 3, 2021·Current Transplantation Reports·Wisit CheungpasitpornDavid A Axelrod
Jan 11, 2022·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Vaka K SigurjonsdottirAbanti Chaudhuri

❮ Previous
Next ❯

Methods Mentioned

BETA
flow cytometry

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.