Document Detail


Effect of induction therapy protocols on transplant outcomes in crossmatch positive renal allograft recipients desensitized with IVIG.
MedLine Citation:
PMID:  16869794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Here we retrospectively examine the efficacy of two antibody induction regimens using Zenapax or Thymoglobulin in patients with positive complement-dependent cytotoxicity crossmatches (CDC-CMXs) desensitized with IVIG (intravenous immunoglobulin). Between January 1999 and March 2005, 97 patients with (+) CDC-CMXs received kidney transplants (43 deceased donors/54 living donors). All patients received at least 2 g/kg IVIG (maximum four doses) until an acceptable CMX was obtained. Patients were divided into two groups: 1. IVIG + Zenapax (n = 58), 2. IVIG + Thymoglobulin (n = 39). A total of 94% of patients in Group 1 and 84% in G2 have at least 2 years of follow up. Patient and graft survival was 96%/84% in Group 1 and 100%/90% in Group 2, p = NS. The number and severity of AR episodes were similar (36% Group 1 vs. 31% Group 2, p = NS) as was the incidence of C4d (+) antibody-mediated rejection (AMR) (Banff Grade II/III) (22% Group 1 vs. 21% Group 2). Mean serum creatinines (SCrs) at 24 months were similar (Group 1: 1.4 +/- 0.7 vs. G2: 1.5 +/- 0.7 mg/dL). Induction therapy with Zenapax or Thymoglobulin results in excellent patient, graft survival and graft function at 2 years. There was no increased risk of viral infections or malignancies with either agent. Neither agent was effective in reducing the incidence of AMR.
Authors:
A A Vo; M Toyoda; A Peng; S Bunnapradist; M Lukovsky; S C Jordan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-07-25
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  6     ISSN:  1600-6135     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-14     Completed Date:  2006-12-19     Revised Date:  2007-02-14    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  2384-90     Citation Subset:  IM    
Affiliation:
Comprehensive Transplant Center, Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, California, USA. Ashley.Vo@cshs.org
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Antibodies, Monoclonal / therapeutic use*
Child
Child, Preschool
Drug Therapy, Combination
Female
Follow-Up Studies
Graft Rejection / immunology,  prevention & control*
Graft Survival
Histocompatibility Testing
Humans
Immunoglobulin G / therapeutic use*
Immunoglobulins, Intravenous / therapeutic use*
Immunologic Factors / therapeutic use*
Immunosuppression / methods
Immunosuppressive Agents / therapeutic use*
Kidney Transplantation / immunology*
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin G; 0/Immunoglobulins, Intravenous; 0/Immunologic Factors; 0/Immunosuppressive Agents; 0/thymoglobulin; 152923-56-3/daclizumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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