Thymoglobulin Induction Therapy in Deceased Donor Kidney Transplantation: Single-Center Experience in Mexico

• Published in: Transplantation proceedings 2016-03, Vol.48 (2), p.596-599
• Main Authors: Martinez-Mier, G, Soto-Miranda, E, Budar-Fernandez, L.F, Mateu-Rivera, L.J, Gomez-Diaz, A, Trujillo-Martinez, M.F, Uscanga-Montesano, A, Avila y Falfan, D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antilymphocyte Serum - administration & dosage; Child; Delayed Graft Function - drug therapy; Delayed Graft Function - epidemiology; Female; Graft Survival - drug effects; Humans; Incidence; Kaplan-Meier Estimate; Kidney Transplantation - adverse effects; Male; Mexico - epidemiology; Middle Aged; Retrospective Studies; Surgery; Survival Rate - trends; Tissue Donors; Treatment Outcome; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2016.02.018

Abstract Background Induction therapy is used to reduce the incidence of graft rejection and delayed graft function. Thymoglobulin is the most used inductor agent in deceased donor kidney transplantation due to its lower rejection and delayed graft function rates. Methods Retrospective study of patients who underwent deceased donor kidney transplantation from 2011 to 2014. Efficacy and safety outcomes evaluated were primary graft nonfunction, delayed graft function, acute rejection episodes, the lowest leukocyte count during the induction, adverse effects, eGFR, and patient and graft survival. P  < .05 was considered statistically significant. Results A total of 42 patients were registered. Of these, 51.7% were female, with a mean age of 36.4 ± 11.1 years. Mean dialysis time was 112.4 ± 365 months. Mean donor age was 33.7 ± 13.1 years. Of the registered patients, 14.3% were extended criteria donors and 23.8% high-risk. Mean thymoglobulin dose was 4.4 ± 0.8 mg/kg. Primary graft nonfunction was 2.4%. Nineteen percent presented with delayed graft function and 19% with acute rejection. Mean lowest leukocyte count was of 4.6 ± 1.5 × 103 cells/mm3 . Mean hospital stay was 11.3 ± 6.3 days. Adverse effects were seen in 59.5% of registered patients, whereas graft survival 1 year and 3 years after transplantation was 85.3% and 56.9%, respectively. Patient survival 1 year and 3 years after transplantation was 85.3% and 53.8%, respectively. Patients who received a higher dose (>4.4 mg/kg) had a shorter hospital stay (9.4 ± 4.6 and 8.1 ± 2.3) than those who received lower dose (13.6 ± 7.9 and 12.8 ± 7.4; P  < .05). Conclusion Thymoglobulin induction at doses near 5 mg/kg in deceased donor kidney transplant is efficient and secure at our center.