Document Detail


Long-term evaluation of single bolus high dose ATG induction therapy for prophylaxis of rejection in live donor kidney transplantation.
MedLine Citation:
PMID:  17978857     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The long-term evaluation of single bolus high dose antithymocyte globulin (ATG) induction therapy has not been adequately studied. We aimed to evaluate its long-term effects in the living related donor kidney transplantation. METHODS: Eighty adult recipients with their first kidney allograft were randomized into two equal treatment groups, one group received intraoperative single bolus rabbit ATG in a dose of 9 mg/kg and the second group served as a control. All patients were maintained on triple immunosuppressive therapy (steroids, calcineurin inhibitor and antiproliferative agent). We followed them thoroughly for minimum of 5 years. RESULTS: ATG significantly reduced the proportion of patients who experienced acute rejection episodes in the first year (9/40) when compared to the control group (26/40) and in 5 years (11/40) when compared to (30/40) in controls. The cumulative steroid dose used throughout the study was significantly lower in the ATG group. The overall incidence of posttransplant complications was comparable among the two treatment groups. There was no significant difference in patient and graft survival: 5 year survival was 100% and 85% for the ATG group, and 95% and 92.5% in the control group, respectively. CONCLUSION: Although routine single bolus ATG induction significantly reduces the incidence of acute rejection, its long-term beneficial effects on graft function and patient and graft survival are not evident.
Authors:
Hussein A Sheashaa; Ahmed F Hamdy; Mohamed A Bakr; Sherif F Abdelbaset; Mohamed A Ghoneim
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  International urology and nephrology     Volume:  40     ISSN:  0301-1623     ISO Abbreviation:  Int Urol Nephrol     Publication Date:  2008  
Date Detail:
Created Date:  2008-08-14     Completed Date:  2008-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  Hungary    
Other Details:
Languages:  eng     Pagination:  515-20     Citation Subset:  IM    
Affiliation:
Urology & Nephrology Center, Mansoura University, Mansoura, Egypt. drhattia@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Antilymphocyte Serum / administration & dosage*
Female
Glucocorticoids / administration & dosage
Graft Rejection / prevention & control*
Humans
Infusions, Intravenous
Kidney Transplantation / immunology*
Living Donors
Male
Methylprednisolone / administration & dosage
Plasma Exchange
Prospective Studies
Chemical
Reg. No./Substance:
0/Antilymphocyte Serum; 0/Glucocorticoids; 83-43-2/Methylprednisolone

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


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