Impact of Small Variations in the Delivered Dose of Rabbit Antithymocyte Induction Therapy in Kidney Transplantation With Early Corticosteroid Withdrawal

• DOI: 10.1097/tp.0b013e318257ad1a
• Publication Date: 2012-07-19T13:22:13Z
• Authors: Demetra S. Tsapepas; Sumit Mohan; Bekir Tanriover; Geoffrey Dube; R. John Crew; David J. Cohen; Mark A. Hardy; P. Rodrigo Sandoval; Lloyd E. Ratner
• Keywords: Leukopenia; Cumulative incidence; Cumulative dose; Maintenance therapy

Optimal dosing of rabbit antithymocyte globulin (rATG) induction therapy in kidney transplantation is not well defined. The impact from variations dose rounding or single limits has been studied.This retrospective study 242 adult renal transplant recipients receiving rATG and steroid-sparing maintenance evaluates the effect small changes dosing. local protocol calls for four doses 1.5 mg/kg, approximated to nearest 25 mg limited a max 150 mg. Patients were stratified by total received 5 6 mg/kg (n=151) (n=91) more. Incidence biopsy-proven acute rejection, patient graft survival, allograft function examined.Baseline characteristics similar between groups except differences mean weight (SD) (81 [17.3] vs. 76.3 [15.6]) cumulative (451.8 [96.2] 481.1 [93]) patients 5- 6-mg/kg group more group, respectively. who showed significantly lower incidence rejection at last follow-up 11% (32/151) 21.2% (10/91) among those only (P<0.042). Renal (mean serum creatinine level) was both 90 days time follow-up. Safety review leukopenia thrombocytopenia did differ.Small administered seem rejection. Adequate associated with improved rejection-free survival should be achieved all patients; rounded up when appropriate additional if necessary.