Renal transplantationOutcomeRandomized Trial of Thymoglobulin Versus Alemtuzumab (with Lower Dose Maintenance Immunosuppression) Versus Daclizumab in Living Donor Renal Transplantation
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Methods and Patients
Between September 2002 and October 2006, we prospectively randomized 38 recipients of LD first kidney transplant recipients of 16 to 66 years of age, using an open label design immediately before transplantation. The institutional review board approved the protocol, and patients provided written informed consent prior to enrollment. Exclusion criteria were similar to other prospective randomized trials performed at our center.11, 12, 13 Group A (n = 13) received thymoglobulin (1 mg/kg/d) for
Results
The distributions of baseline demographic features are reported in Table 1. There were no significant differences among the three groups regarding age, presence of type 2 diabetes, race/ethnicity, gender, donor age, or total human leukocyte antigen (HLA) mismatches. The percentages of African-Americans and Hispanics combined were 46%, 54%, and 50% in groups A, B, and C, respectively. Note that 35/38 patients received a living related donor kidney; the three patients who received a living
Discussion
In September 2002, we embarked on this three-arm prospective, open label, randomized trial of single-agent induction therapy among first LD kidney transplant recipients with the following goals: (1) to determine the overall safety and efficacy of administering alemtuzumab versus thymoglobulin or daclizumab, and (2) to assess in a long-term study the safety of lower CI concentrations and steroid avoidance in the alemtuzumab arm. Early results of a similarly conducted randomized trial among 90
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Cited by (34)
Rabbit anti-thymocyte globulin for the prevention of acute rejection in kidney transplantation
2019, American Journal of TransplantationEfficacy and Safety of Induction Therapy in Kidney Transplantation: A Network Meta-Analysis
2018, Transplantation ProceedingsAnesthesia and Perioperative Care in Reconstructive Transplantation
2017, Anesthesiology ClinicsCitation Excerpt :Premedication with steroids (bolus methylprednisolone), along with diphenhydramine and acetaminophen, may be helpful to minimize risk of CRS. In contrast to alemtuzumab and thymoglobulin, basiliximab and daclizumab have a superior safety profile (similar to placebo) and do not cause CRS.34,40–42 However, rare hypersensitive reactions can occur with these agents, resulting in intraoperative or perioperative hypotension, tachycardia, cardiac failure, bronchospasm, pulmonary edema, and respiratory failure.43
Randomized trial of rATg/Daclizumab vs. rATg/Alemtuzumab as dual induction therapy in renal transplantation: Results at 8 years of follow-up
2017, Transplant ImmunologyCitation Excerpt :In both groups, tacrolimus was initiated at 0.1 mg/kg twice daily once renal function improved (serum creatinine concentration (Cr) < 4 mg/dl absent dialysis), with a target (12 h) trough level of 4–8 ng/ml. Target enteric-coated mycophenolate sodium(EC-MPS) dosing was 720 mg vs. 360 mg twice daily for Groups I and II, respectively; one-half of standard daily EC-MPS dosing was targeted in Group II in order to avoid severe leukopenia previously seen with C1H [5–8]. Any withholding of EC-MPS for at least 2 weeks was documented along with reasons for withholding.