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The appropriate dose of thymoglobulin induction therapy in kidney transplantation
Author(s) -
Nafar Mohsen,
Dalili Nooshin,
PoorRezaGholi Fatemeh,
Ahmadpoor Pedram,
Samadian Fariba,
Samavat Shiva
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12977
Subject(s) - thymoglobulin , medicine , transplantation , kidney transplantation , urology , randomized controlled trial , renal function , kidney , bolus (digestion) , surgery , kidney disease
Background Thymoglobulin is used effectively as an induction agent in kidney transplantation, but there is no consensus on the optimal dose. In order to delineate the safest effective dose, an open‐labeled randomized clinical trial was designed. Methods In this study, 90 adult kidney transplant recipients ( KTR ) were randomized before transplantation in three groups to receive thymoglobulin: Arm A (4.5 mg/kg in 3 days), Arm B (4.5 mg/kg single bolus dose), and Arm C (6 mg/kg in 3 days). Renal function, infections, and rate of readmissions were evaluated during the first post transplantation year. Results Ninety adult kidney recipients were enrolled (51% deceased donor). No significant statistical difference was found in acute rejection episodes or type of rejection between these groups, although patients in Arm A showed more severe histopathologic changes according to Banff 2013 criteria, in renal biopsies ( P =.03). At the first month after transplantation serum Cr was lower ( P =.001) and GFR was higher ( P =.04) in Arm A, but there was no significant difference among the three groups at 3, 6, and 12 months post‐transplant. Conclusion Although all regimens showed the same efficacy regarding the rate of rejection episodes, 3‐day 4.5 mg/kg Thymoglobulin had significantly fewer complications.