Analysis of infusion‐site reactions in renal transplant recipients receiving peripherally administered rabbit antithymocyte globulin as compared with basiliximab

Antithymocyte globulin rabbit (r‐ATG) has been used for the treatment and prevention of acute rejection in renal transplant recipients (RTR). Current manufacturer recommendations for r‐ATG dictate the need for administration through a high‐flow vein (central line). Previous studies have shown peripheral administration of r‐ATG to be safe; however, these studies suggest the co‐administration of heparin and hydrocortisone and did not compare the infusion‐site reaction rates to a control group. A retrospective analysis was conducted of adult RTR receiving r‐ATG or basiliximab between January 2004 and October 2006. Each agent was administered through a dedicated peripheral line. The primary endpoint was the incidence of infusion‐site reactions. Other endpoints included the need to replace the intravenous catheter and the incidence of systemic thrombosis within 1 month of transplantation. During the study period, 152 peripheral infusions of r‐ATG and 92 peripheral infusions of basiliximab were administered. No difference in infusion‐site reactions was noted between the groups. There was also no difference either in the need for peripheral line replacement or the rates of systemic thrombosis. Peripheral administration of r‐ATG is safe and can be infused without concomitant heparin and hydrocortisone. This method of r‐ATG infusion was shown to be as safe as peripherally administered basiliximab.