TY - JOUR
T1 - Thymoglobulin versus ATGAM induction therapy in pediatric kidney transplant recipients
T2 - A single-center report
AU - Khositseth, Sookkasem
AU - Matas, Arthur J
AU - Cook, Marie E.
AU - Gillingham, Kristen J
AU - Chavers, Blanche M
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2005/4/27
Y1 - 2005/4/27
N2 - Background. Induction immunosuppressive therapy with the anti-T-cell antibody Thymoglobulin decreases the incidence of acute rejection in adult kidney transplant (KTx) recipients, but limited data are available for pediatric KTx recipients. Methods. We conducted a historical cohort study to compare rates of survival, rejection, and infection in pediatric (age <19 years) KTx recipients who received induction therapy with polyclonal antibody, ATGAM (n=127) or Thymoglobulin (n=71), from December 1, 1992, to January 31, 2003. Maintenance immunosuppression included cyclosporine, azathioprine or mycophenolate mofetil, and prednisone. Mean follow-up was 90±25 months for ATGAM recipients and 32±15 months for Thymoglobulin recipients. Results. Overall, the incidence of acute rejection was lower in Thymoglobulin recipients versus ATGAM recipients (33% vs. 50%, P=0.02). Epstein-Barr virus (EBV) infection was higher in Thymoglobulin recipients versus ATGAM recipients (8% vs. 3%, P=0.002). But the two groups did not significantly differ in patient and graft survival rates, incidence of chronic rejection, EBV lymphoma, or other infection. Conclusions. Thus, Thymoglobulin induction was associated with a decreased incidence of acute rejection and an increased incidence of EBV infection in pediatric KTx recipients. EBV monitoring should be performed in EBV-naive recipients receiving Thymoglobulin.
AB - Background. Induction immunosuppressive therapy with the anti-T-cell antibody Thymoglobulin decreases the incidence of acute rejection in adult kidney transplant (KTx) recipients, but limited data are available for pediatric KTx recipients. Methods. We conducted a historical cohort study to compare rates of survival, rejection, and infection in pediatric (age <19 years) KTx recipients who received induction therapy with polyclonal antibody, ATGAM (n=127) or Thymoglobulin (n=71), from December 1, 1992, to January 31, 2003. Maintenance immunosuppression included cyclosporine, azathioprine or mycophenolate mofetil, and prednisone. Mean follow-up was 90±25 months for ATGAM recipients and 32±15 months for Thymoglobulin recipients. Results. Overall, the incidence of acute rejection was lower in Thymoglobulin recipients versus ATGAM recipients (33% vs. 50%, P=0.02). Epstein-Barr virus (EBV) infection was higher in Thymoglobulin recipients versus ATGAM recipients (8% vs. 3%, P=0.002). But the two groups did not significantly differ in patient and graft survival rates, incidence of chronic rejection, EBV lymphoma, or other infection. Conclusions. Thus, Thymoglobulin induction was associated with a decreased incidence of acute rejection and an increased incidence of EBV infection in pediatric KTx recipients. EBV monitoring should be performed in EBV-naive recipients receiving Thymoglobulin.
KW - Infection
KW - Pediatric kidney transplantation
KW - Rejection
KW - Thymoglobulin
UR - http://www.scopus.com/inward/record.url?scp=17844405620&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=17844405620&partnerID=8YFLogxK
U2 - 10.1097/01.TP.0000158325.12837.A2
DO - 10.1097/01.TP.0000158325.12837.A2
M3 - Article
C2 - 15849550
AN - SCOPUS:17844405620
SN - 0041-1337
VL - 79
SP - 958
EP - 963
JO - Transplantation
JF - Transplantation
IS - 8
ER -