Thymoglobulin Induction Dosing Strategies in a Low-Risk Kidney Transplant Population: Three or Four Days?

• Published in: Journal of Transplantation Vol. 2010; no. 2010; pp. 150 - 157
• Main Authors: Hardinger, Karen L., Rasu, Rafia S., Skelton, Rebecca, Miller, Brent W., Brennan, Daniel C.
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Limiteds 01.01.2010; Hindawi Puplishing Corporation; Hindawi Publishing Corporation; Wiley
• Subjects: Clinical Study
• ISSN: 2090-0007; 2090-0015
• DOI: 10.1155/2010/957549

The optimal dose and duration of rabbit antithymocyte globulin (rATG) induction has not been defined. Methods. We compared the safety and efficacy of 2 dosing strategies, rATG 1.5 mg/kg for 4 days (n=59) versus 2 mg/kg for 3 days (n=59), in a retrospective, cohort study. Results. Two-year rejection-free survival was 95% in each group (P=.983). Renal function and infection rates were similar. The incidence of leucopenia was similar, although the 2 mg/kg group was more likely to be thrombocytopenic on day 2 (4% versus 28%, P=.04). Length of stay tended to be longer for the 1.5 mg/kg group (6.0±3.7 versus 5.1±1.9 days P=.104). A cost savings of $920 per patient for rATG were seen in the 2 mg/kg group (P=.122). Conclusions. Shorter, more intense dosing of rATG is safe and effective. The 3-day dose strategy resulted in a clinically shorter length of stay and may result in cost savings.