TY - JOUR
T1 - Five-year follow up of thymoglobulin versus ATGAM induction in adult renal transplantation
AU - Hardinger, Karen L.
AU - Schnitzler, Mark A.
AU - Miller, Brent
AU - Lowell, Jeffrey A.
AU - Shenoy, Surendra
AU - Koch, Matthew J.
AU - Enkvetchakul, Decha
AU - Ceriotti, Connie
AU - Brennan, Daniel C.
PY - 2004/7/1
Y1 - 2004/7/1
N2 - Background. One-year results of a randomized, double-blinded trial of Thymoglobulin versus Atgam for induction therapy in renal transplantation revealed that Thymoglobulin was associated with higher event-free survival (94% vs. 63%), less acute rejection (4% vs. 25%), and better graft survival. This article compares the safety and efficacy of Thymoglobulin versus Atgam induction through 5 years. Methods. Review and analysis of clinic records and electronic databases. Results. At 5 years, event-free survival (73% vs. 33%, P<0.001), graft survival (77% vs. 55%, P=0.047), and freedom from rejection (92% vs. 66%, P=0.007) were higher with Thymoglobulin versus Atgam. No additional cytomegalovirus (CMV) disease occurred after the first year with Thymoglobulin or Atgam (13% vs. 33%, P=0.056). There were two cases of posttransplant lymphoproliferative disorder (PTLD) with the Atgam arm and none with Thymoglobulin. Thymoglobulin was associated with profound lymphopenia at 2 years after transplantation. Conclusions. Thymoglobulin was associated with higher event-free survival, graft survival, and freedom from rejection without increased PTLD or CMV disease at 5 years compared with Atgam. The prolonged and profound lymphopenia may contribute to the long-term results associated with Thymoglobulin.
AB - Background. One-year results of a randomized, double-blinded trial of Thymoglobulin versus Atgam for induction therapy in renal transplantation revealed that Thymoglobulin was associated with higher event-free survival (94% vs. 63%), less acute rejection (4% vs. 25%), and better graft survival. This article compares the safety and efficacy of Thymoglobulin versus Atgam induction through 5 years. Methods. Review and analysis of clinic records and electronic databases. Results. At 5 years, event-free survival (73% vs. 33%, P<0.001), graft survival (77% vs. 55%, P=0.047), and freedom from rejection (92% vs. 66%, P=0.007) were higher with Thymoglobulin versus Atgam. No additional cytomegalovirus (CMV) disease occurred after the first year with Thymoglobulin or Atgam (13% vs. 33%, P=0.056). There were two cases of posttransplant lymphoproliferative disorder (PTLD) with the Atgam arm and none with Thymoglobulin. Thymoglobulin was associated with profound lymphopenia at 2 years after transplantation. Conclusions. Thymoglobulin was associated with higher event-free survival, graft survival, and freedom from rejection without increased PTLD or CMV disease at 5 years compared with Atgam. The prolonged and profound lymphopenia may contribute to the long-term results associated with Thymoglobulin.
UR - http://www.scopus.com/inward/record.url?scp=3142726205&partnerID=8YFLogxK
U2 - 10.1097/01.TP.0000132329.67611.3F
DO - 10.1097/01.TP.0000132329.67611.3F
M3 - Article
C2 - 15257052
AN - SCOPUS:3142726205
VL - 78
SP - 136
EP - 141
JO - Transplantation
JF - Transplantation
SN - 0041-1337
IS - 1
ER -