PMID- 16182802
OWN - NLM
STAT- MEDLINE
DCOM- 20060124
LR  - 20050926
IS  - 0041-1345 (Print)
IS  - 0041-1345 (Linking)
VI  - 37
IP  - 6
DP  - 2005 Jul-Aug
TI  - Immunosuppression with antithymocyte globulin in renal transplantation: better 
      long-term graft survival.
PG  - 2755-8
AB  - We analyzed the impact of antithymocyte globulin (ATG) in renal transplantation. 
      We retrospectively studied 1217 recipients performed from July 83 to December 03. 
      ATG-Fresenius-S (ATG-F) was used for induction therapy in 492 patients (40.4%; 
      group I) and compared with group II, 725 patients (59.6%), without antilymphocyte 
      induction. Groups were comparable in terms of recipient gender and race 
      distribution; time on dialysis; cause of renal disease; number of human leukocyte 
      antigen (HLA) mismatches; donor age, gender, and creatinine; and cold ischemia 
      time. Patients with ATG-F were younger (35.8 +/- 13.8 vs 38.9 +/- 12.5 years, P < 
      .001), more frequently hypersensitized (10% vs 3%, P < .001), and had more second 
      transplants (15.7% vs 5.8%, P < .001). The incidence of acute rejection episodes 
      was lower among ATG-F patients (23.6% vs 32.1%, P = .004). Admission time and 
      incidence of delayed graft function (DGF) were similar in the two groups. Graft 
      survival at 1, 5, 10, and 15 years was 88.9%, 80.7%, 71.3%, and 64.9% in group I 
      and 86.4%, 77.4%, 60.7%, and 48.4% in group II (P = .003). The difference in 
      patient survival over the same follow-up did not reach statistical significance. 
      Multivariate analysis showed that the risk of graft failure was higher for those 
      who did not receive ATG-F (HR = 1.51; 95% CI, 1.14 to 2.00; P = .004). Donor age 
      and DGF were also independent predictors of graft failure. Our results showed a 
      better long-term graft survival among patients who received ATG-F, despite their 
      higher immunological risk. The absence of induction with ATG-F, donor age, and 
      DGF were independent risk factors for graft failure.
FAU - Martins, L
AU  - Martins L
AD  - Nephrology Department, Hospital Santo Antonio, Porto, Portugal. lasalete@clix.pt
FAU - Fonseca, I
AU  - Fonseca I
FAU - Almeida, M
AU  - Almeida M
FAU - Henriques, A C
AU  - Henriques AC
FAU - Dias, L
AU  - Dias L
FAU - Sarmento, A M
AU  - Sarmento AM
FAU - Cabrita, A
AU  - Cabrita A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Antilymphocyte Serum/*therapeutic use
MH  - Follow-Up Studies
MH  - Graft Survival/drug effects/*immunology
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kidney Transplantation/*immunology/mortality
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Time Factors
EDAT- 2005/09/27 09:00
MHDA- 2006/01/25 09:00
CRDT- 2005/09/27 09:00
PHST- 2005/09/27 09:00 [pubmed]
PHST- 2006/01/25 09:00 [medline]
PHST- 2005/09/27 09:00 [entrez]
AID - S0041-1345(05)00542-7 [pii]
AID - 10.1016/j.transproceed.2005.05.003 [doi]
PST - ppublish
SO  - Transplant Proc. 2005 Jul-Aug;37(6):2755-8. doi: 
      10.1016/j.transproceed.2005.05.003.