Thymoglobulin and Rate of Infectious Complications After Transplantation

• Published in: Transplantation proceedings 2007-03, Vol.39 (2), p.463-464
• Main Authors: Clesca, P, Dirlando, M, Park, S.-I, García, R, Ferraz, E, Pinheiro-Machado, P.G, Kushnaroff, L, Tedesco-Silva, H, Medina-Pestana, J.O
• Format: Article
• Language: English
• Subjects: Adult; Antibodies, Monoclonal - blood; Antilymphocyte Serum; Biological and medical sciences; Cadaver; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Histocompatibility Testing; Humans; Infection - epidemiology; Kidney Transplantation - adverse effects; Kidney Transplantation - immunology; Male; Medical sciences; Middle Aged; Postoperative Complications - epidemiology; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue Donors; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2007.01.024

Abstract Thymoglobulin is used as an induction agent in kidney transplantation, but the optimal dose is not well established. However, its use may be associated with increased infectious complications after transplantation. Methods This retrospective study of 61 high-risk renal recipients of transplants from deceased donors performed between June 2001 and April 2004 included patients treated with thymoglobulin. Patients were divided into two groups according to the total thymoglobulin dose (G1, n = 30, 7 mg/kg) and followed for at least 1 year. Results Mean recipient age was 43 ± 14 years; 41% were males; 63% non-Whites. Mean cold ischemia time was 26.3 ± 7 hours. Mean PRA was 23% (0–100%). Second transplantation was performed in 18 (29.5%) patients. Mean donor age was 42.1 ± 16 years, and 59% had a cerebral vascular accident as the cause of death. Patient- and death-censored graft survival at 12 months were 86% and 88%, respectively. There were 149 infectious episodes among 47 (78%) patients. The incidence of infection was 1.7 ± 0.24 infections per patient per year in G1 (lower dose) vs 3.12 ± 0.23 in G2 ( P < .001). Bacterial (0.66 ± 1.0 vs 1.48 ± 1.26 infections per patient per year, P = .009) and viral infections (0.9 ± 0.71 vs 1.41 ± 0.71; P = .006) were more frequent in the higher dose group. Conclusion This study suggested that a greater number of infectious episodes were present when the total dose of thymoglobulin was higher than 7 mg/kg.