Single-Dose Anti-Thymocyte Globulin Compared With Divided-Dose for Induction Therapy in Kidney Transplantation in a Predominantly Black Population |
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| Institution: | 1. Department of Pharmacy, Sentara Norfolk General Hospital, Norfolk, Virginia;2. Sound Physicians, Richmond Community Hospital, Richmond, Virginia;3. Division of Nephrology, Eastern Virginia Medical School, Norfolk, Virginia;4. Department of Surgery, Sentara Norfolk General Hospital, Norfolk, Virginia;5. Kidney/Pancreas Transplant Department, Sentara Norfolk General Hospital, Norfolk, Virginia;6. Transplant Department, Children''s Hospital of the King''s Daughters, Norfolk, Virginia;7. Tidewater Kidney Specialists, Norfolk, Virginia;1. Department of Surgery and Surgical Intensive Care, University Hospital Regensburg, Regensburg, Germany;2. Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany;1. Department of Nephrology, Internal Medicine and Transplantation, Pomeranian Medical University, Szczecin, Poland;2. Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland;1. Department of Nephrology, University Hospital of Marburg, UKGM GmbH, Marburg, Germany;2. Department of Diagnostic and Interventional Radiology, University Hospital of Marburg, UKGM GmbH, Marburg, Germany;1. Department of Urology, University Hospital, Nancy, France;2. Division of Urology, University of São Paulo, São Paulo, Brazil;3. Clinical Epidemiology Center CIC 1433 Inserm, University Hospital, Nancy, France;4. University Hospital, Site Hôtel-Dieu, Nantes, France;5. Department of Nephrology, University Hospital, Nancy, France;6. IADI-UL-INSERM (U1254), University Hospital, Nancy, France;1. Department of Surgery, Toranomon Hospital Kidney Center, Tokyo, Japan;2. Toranomon Hospital Kajigaya Urology, Tokyo, Japan;1. Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;2. Division of Nephrology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;3. Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;4. Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania |
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| Abstract: | BackgroundThe aim of this study was to compare single-dose rabbit anti-thymocyte globulin (rATG) with a divided dose in kidney transplant recipients within a majority Black patient population.MethodsWe analyzed the outcomes before and after a change in protocol from divided-dose (1.5 mg/kg/day over 4 days) to single-dose (6 mg/kg over 24 hours) rATG in a retrospective cohort study. All patients who received rATG for kidney transplant induction between December 2015 and July 2018 were included.ResultsA total of 197 patients (n = 98 in the divided-dose group, n = 99 in the single-dose group) received rATG. There was no difference in time to rejection at 1 year (P = .82) or incidence of rejection (P = .80). There was also no difference in delayed graft function, serum creatinine, or survival at 1 year. Patients in the single-dose group were more likely to leave the hospital by postoperative day 3 (12% vs 2%, P = .006). The cytomegalovirus infection rate was higher in the single-dose group (P = .031).ConclusionsUse of a single-dose rATG regimen is an acceptable accelerated induction compared with the standard divided dose for induction therapy in kidney transplant in a predominantly Black population. |
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