Thymoglobulin as an induction therapy: protection against ischemia and reperfusion injury

• Published in: Einstein (São Paulo, Brazil) Vol. 4; no. 4; pp. 315 - 320
• Main Authors: Lúcio Roberto Requião Moura, Maurício Galvão Pereira, Marcelino Durão, Eduardo José Tonato, Ana Cristina Carvalho Matos, Eric Roger Wroclawski, Alvaro Pacheco-Silva
• Format: Journal Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 01.12.2006
• Subjects: acute; Antibodies; Ischemia; Kidney transplantation; Kidney tubular necrosis; monoclonal/therapeutic use; Reperfusion
• ISSN: 1679-4508

Objective: To asses graft function and survival after one year inpatients at high risk of acute tubular necrosis (ATN) and to definethe impact of this lesion on allograft function in patients whoutilized an induction protocol with Thymoglobulin (Thymo).Methods: Thymo was utilized as an induction strategy. CD3+cells counting was monitored. Graft function and survival wasdemonstrated. Results: Seventy-eight patients who receivedkidneys from cadaveric donors utilized the referred protocol.Follow-up was 2 years. Cold ischemia time was 19.9 ± 4.8 hours.Thymo total doses was 7.48 ± 3.7. CD3+ cells counting was19.3 ± 22.3. Acute rejection occurred in 14.1% of cases, ATN in66.6% and CMV infection in 55.1%. One-year graft survival noncensoredby death was 95.9%, and serum creatinine was 1.56 ±0.53 mg/dl. Patients who presented ATN had longer length ofhospital stay (18.8 ± 6.1 vs. 10.4 ± 4.3 days, p < 0.010) andworse serum creatinine levels (1.66 ± 0.4 vs. 1.39 ± 0.6 mg/dl,p = 0.003). The only one variable related with graft function wasdonor age (when > 38 years, RR = 3.43, p < 0.001). Conclusion:Thymoglobulin induction provided an excellent graft survival anda low rate of acute rejection and good graft function until 2 yearsafter transplantation, despite high prevalence of ATN.