Polyclonal Antithymocyte Globulin and Cardiovascular Disease in Kidney Transplant Recipients

• DOI: 10.1681/asn.2013060663
• Publication Date: 2014-02-08T07:51:56Z
• Authors: Didier Ducloux; Cécile Courivaud; Jamal Bamoulid; Thomas Crepin; Jean-Marc Chalopin; Pierre Tiberghien; Philippe Saas
• Keywords: Cumulative incidence

T-lymphocyte activation may contribute to atherosclerosis, the prevalence of which is increased in transplant patients. However, cardiovascular consequences polyclonal antithymocyte globulin (ATG)-induced immune modifications, include alterations T-cell subsets, are unknown. We conducted a retrospective single-center study assess whether ATG associates with an incidence atherosclerotic events (CVEs) kidney Propensity score analysis was performed address potential confounding by indication. also tested use induces proatherogenic status. Sixty-nine (12.2%) CVEs occurred during follow-up (87±31 months). The cumulative higher ATG-treated patients (14.7% versus 8.2%; P=0.03). Cox regression revealed that independent risk factor for (hazard ratio [HR], 2.36; 95% confidence interval [95% CI], 1.35 4.13; P=0.003). Results obtained propensity match recapitulated those from overall cohort (HR, 2.09; CI, 1.11 3.98; P=0.02). Late-stage differentiated CD8(+) T cells 1 year after transplantation only More generally, associated features activation. These modifications markedly exposed cytomegalovirus (CMV). Subanalyses suggest effect on restricted CMV-exposed CMV infection significantly 2.07; 1.16 3.70; P=0.01). In conclusion, both and post-transplant this cohort. Further studies should precisely determine ATG-induced causal link between CVEs.