Effect of Prophylaxis With Low-Dose Anti-Thymocyte Globulin on Prevention of Acute Kidney Allograft Rejection

H. T. Khosroshahi, R. S. Tubbs, Mohammadali Mohajel Shoja, A. Ghafari, H. Noshad, M. R. Ardalan

Research output: Contribution to journalArticle

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Abstract

Introduction: During kidney transplantation, the first contact between the recipient's immune system and the donor organ takes place immediately following the arterial anastomosis. The aim of this study was to evaluate the efficacy of a single, low-dose anti-thymocyte globulin (ATG) prophylaxis in the reduction of early acute rejection in renal allograft recipients. Methods: In a randomized, controlled clinical trial, we studied the rate of acute rejection within the first month of kidney transplantation in patients who had received their transplant at a single center between the years 2004 and 2007. The patients were divided into 2 groups: group 1 (n = 37) received cyclosporine, mycophenolate mofetil or azathioprine, and prednisolone; group 2 (n = 31) received the above-mentioned agents plus a single ATG bolus (Thymoglobulin; SangStat, Lyon, France; 4-5 mg/kg) the night before the transplantation (∼12 hours before the operation). Blood urea and serum creatinine levels were measured regularly in the posttransplantation period. Acute allograft rejection was justified clinically and/or pathologically. Statistical analysis was performed by SPSS 13.0 using Student t test and Fisher exact test. A P value ≤ .05 was considered to indicate statistical significance. Results: There were no significant differences regarding the age and gender ratio between the 2 groups. Acute allograft rejection was found in 32.4% (n = 12) of group 1 patients, and was reduced to 12.9% (n = 4) in group 2 (P = .05). Hence, the first-month acute rejection episodes decreased by ∼60% with ATG prophylaxis in renal transplant recipients. Conclusion: Prophylactic administration of a single and low-dose ATG the night before kidney transplantation could reduce the risk of acute allograft rejection in renal transplant recipients. However, further studies with a greater number of patients should be conducted to confirm these results.

Original languageEnglish (US)
Pages (from-to)137-139
Number of pages3
JournalTransplantation Proceedings
Volume40
Issue number1
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

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Antilymphocyte Serum
Allografts
Kidney Transplantation
Kidney
Mycophenolic Acid
Azathioprine
Prednisolone
Cyclosporine
France
Urea
Immune System
Creatinine
Randomized Controlled Trials
Transplantation
Tissue Donors
Students
Transplants
Serum
Transplant Recipients

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Effect of Prophylaxis With Low-Dose Anti-Thymocyte Globulin on Prevention of Acute Kidney Allograft Rejection. / Khosroshahi, H. T.; Tubbs, R. S.; Mohajel Shoja, Mohammadali; Ghafari, A.; Noshad, H.; Ardalan, M. R.

In: Transplantation Proceedings, Vol. 40, No. 1, 01.01.2008, p. 137-139.

Research output: Contribution to journalArticle

Khosroshahi, H. T. ; Tubbs, R. S. ; Mohajel Shoja, Mohammadali ; Ghafari, A. ; Noshad, H. ; Ardalan, M. R. / Effect of Prophylaxis With Low-Dose Anti-Thymocyte Globulin on Prevention of Acute Kidney Allograft Rejection. In: Transplantation Proceedings. 2008 ; Vol. 40, No. 1. pp. 137-139.
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abstract = "Introduction: During kidney transplantation, the first contact between the recipient's immune system and the donor organ takes place immediately following the arterial anastomosis. The aim of this study was to evaluate the efficacy of a single, low-dose anti-thymocyte globulin (ATG) prophylaxis in the reduction of early acute rejection in renal allograft recipients. Methods: In a randomized, controlled clinical trial, we studied the rate of acute rejection within the first month of kidney transplantation in patients who had received their transplant at a single center between the years 2004 and 2007. The patients were divided into 2 groups: group 1 (n = 37) received cyclosporine, mycophenolate mofetil or azathioprine, and prednisolone; group 2 (n = 31) received the above-mentioned agents plus a single ATG bolus (Thymoglobulin; SangStat, Lyon, France; 4-5 mg/kg) the night before the transplantation (∼12 hours before the operation). Blood urea and serum creatinine levels were measured regularly in the posttransplantation period. Acute allograft rejection was justified clinically and/or pathologically. Statistical analysis was performed by SPSS 13.0 using Student t test and Fisher exact test. A P value ≤ .05 was considered to indicate statistical significance. Results: There were no significant differences regarding the age and gender ratio between the 2 groups. Acute allograft rejection was found in 32.4{\%} (n = 12) of group 1 patients, and was reduced to 12.9{\%} (n = 4) in group 2 (P = .05). Hence, the first-month acute rejection episodes decreased by ∼60{\%} with ATG prophylaxis in renal transplant recipients. Conclusion: Prophylactic administration of a single and low-dose ATG the night before kidney transplantation could reduce the risk of acute allograft rejection in renal transplant recipients. However, further studies with a greater number of patients should be conducted to confirm these results.",
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AU - Tubbs, R. S.

AU - Mohajel Shoja, Mohammadali

AU - Ghafari, A.

AU - Noshad, H.

AU - Ardalan, M. R.

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AB - Introduction: During kidney transplantation, the first contact between the recipient's immune system and the donor organ takes place immediately following the arterial anastomosis. The aim of this study was to evaluate the efficacy of a single, low-dose anti-thymocyte globulin (ATG) prophylaxis in the reduction of early acute rejection in renal allograft recipients. Methods: In a randomized, controlled clinical trial, we studied the rate of acute rejection within the first month of kidney transplantation in patients who had received their transplant at a single center between the years 2004 and 2007. The patients were divided into 2 groups: group 1 (n = 37) received cyclosporine, mycophenolate mofetil or azathioprine, and prednisolone; group 2 (n = 31) received the above-mentioned agents plus a single ATG bolus (Thymoglobulin; SangStat, Lyon, France; 4-5 mg/kg) the night before the transplantation (∼12 hours before the operation). Blood urea and serum creatinine levels were measured regularly in the posttransplantation period. Acute allograft rejection was justified clinically and/or pathologically. Statistical analysis was performed by SPSS 13.0 using Student t test and Fisher exact test. A P value ≤ .05 was considered to indicate statistical significance. Results: There were no significant differences regarding the age and gender ratio between the 2 groups. Acute allograft rejection was found in 32.4% (n = 12) of group 1 patients, and was reduced to 12.9% (n = 4) in group 2 (P = .05). Hence, the first-month acute rejection episodes decreased by ∼60% with ATG prophylaxis in renal transplant recipients. Conclusion: Prophylactic administration of a single and low-dose ATG the night before kidney transplantation could reduce the risk of acute allograft rejection in renal transplant recipients. However, further studies with a greater number of patients should be conducted to confirm these results.

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