Five-year follow up of thymoglobulin versus ATGAM induction in adult renal transplantation

Karen L. Hardinger, Mark A. Schnitzler, Brent Miller, Jeffrey A. Lowell, Surendra Shenoy, Matthew J. Koch, Decha Enkvetchakul, Connie Ceriotti, Daniel C. Brennan

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101 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)136-141
Number of pages6
JournalTransplantation
Volume78
Issue number1
DOIs
StatePublished - Jul 1 2004

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    Hardinger, K. L., Schnitzler, M. A., Miller, B., Lowell, J. A., Shenoy, S., Koch, M. J., Enkvetchakul, D., Ceriotti, C., & Brennan, D. C. (2004). Five-year follow up of thymoglobulin versus ATGAM induction in adult renal transplantation. Transplantation, 78(1), 136-141. https://doi.org/10.1097/01.TP.0000132329.67611.3F