Rabbit antithymocyte induction and dosing in deceased donor renal transplant recipients over 60 yr of age. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Antithymocyte globulin (rATG) is a commonly used induction agent in renal transplantation; however, data in older kidney recipients are limited. METHODS: We reviewed charts of 301 deceased donor renal transplants who received a protocol consisting of 3-7 doses of rATG and triple maintenance therapy. Outcomes of patients >60 yr of age (n = 45) were compared to those aged 18-59 yr (n = 256). RESULTS: Older recipients had more diabetics, were more likely to receive expanded criteria donor kidneys (p < 0.01), and over 30% were sensitized. Recipients >60 received less cumulative rATG (4.6 vs. 5.1 mg/kg; p < 0.01). Three-yr acute rejection was lower in the >60 group (2% vs. 16%, p < 0.01) although glomerular filtration rates were similar between groups. Actuarial graft survival was similar; however, patient survival in the >60 group at three yr was lower (80% vs. 95%; p = 0.02). Specifically, patients >60 with delayed graft function and rATG cumulative dosing >6 mg/kg had a survival of <50% by two yr. CONCLUSION: Recipients over 60 yr receiving rATG induction have acceptable renal function and a low risk of rejection; however, reduced survival was noted among those receiving >6 mg/kg. These data suggest that when used, lower cumulative dosages of rATG are preferable in the older recipient.

publication date

  • January 13, 2011

Research

keywords

  • Antilymphocyte Serum
  • Graft Rejection
  • Graft Survival
  • Immunosuppressive Agents
  • Kidney Transplantation
  • Tissue Donors

Identity

Scopus Document Identifier

  • 79958747834

Digital Object Identifier (DOI)

  • 10.1111/j.1399-0012.2010.01393.x

PubMed ID

  • 21231963

Additional Document Info

volume

  • 25

issue

  • 3