One-Year Outcomes with Use of Anti-T-Lymphocyte Globulin in Patients Undergoing Kidney Transplantation: Results from a Prospective, Multicentric, Observational Study from India

• Published in: Advances in therapy 2022-10, Vol.39 (10), p.4533-4541
• Main Authors: Gang, Sishir, Gulati, Sanjeev, Bhalla, Anil K., Varma, Prem P., Bansal, Ravi, Abraham, Abi, Ray, Deepak S., John, Mammen M., Bansal, Shyam B., Sharma, Raj K., Vishwanath, S.
• Format: Article
• Language: English
• Subjects: Adult; Cardiology; Endocrinology; Female; Graft Rejection - prevention & control; Humans; Immunosuppressive Agents - therapeutic use; Internal Medicine; Kidney Transplantation - adverse effects; Lymphocytes; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Research; Pharmacology/Toxicology; Prospective Studies; Rheumatology
• ISSN: 0741-238X; 1865-8652
• DOI: 10.1007/s12325-022-02225-y

Introduction Large-scale Indian data on the use of anti-T-lymphocyte globulin (ATLG) (Grafalon ® ) as induction therapy in kidney transplantation (KT) patients is lacking. The aim of this study was to determine the 1-year patient and graft survival outcomes with the use of ATLG as induction regimen in KT. Methods In a prospective, multicentric, observational study, adult patients who underwent ABO-compatible KT and had received ATLG as a part of induction were included in the study. The primary outcome measure was overall survival and death-censored graft survival at 12 months. The primary safety outcome was assessed by development of infectious complications and graft rejection. Results In total, 359 patients were included in this study. The mean age was 42.77 ± 12.30 years and 83% were male. The average ATLG dose per patient was 6.2 ± 2.2 mg/kg whereas average cumulative dose per patient was 389.6 ± 149.8 mg. The rate of graft dysfunction was 13.4% of patients and 6.7% had biopsy-proven acute rejection (BPAR). There were a total of 12 (3.3%) deaths and one graft loss. Overall survival and death-censored graft survival at 12 months were 96.65% and 99.44%, respectively. The rate of infections was 13.6% with urinary tract infections being most common. Conclusion ATLG at an average dose of 6 mg/kg is an effective and safe induction regimen immunosuppressant for ABO-compatible KT with favourable impact on survival and graft function in Indian patients.