Grafalon® vs. Thymoglobulin® as an Induction Agent in Renal Transplantation - A Retrospective Study
Copyright: © 2020 Indian Journal of Nephrology..
INTRODUCTION: Antihuman thymocyte immunoglobulin, used as an induction agent in renal transplantation, is of two types - thymoglobulin and grafalon (formerly ATG-Fresenius). In this study, we compared outcomes with these two agents.
METHODS: This was a single-center retrospective study of patients transplanted from January 2017 to October 2019, who received either grafalon or thymoglobulin induction. Grafalon or thymoglobulin was given at 6 and 3 mg/kg, respectively, followed by standard triple immunosuppression of tacrolimus, MMF, and prednisolone.
RESULTS: Median follow up was 22 (3-36) months. Thymoglobulin was given to 255 patients, whereas 78 patients received grafalon. Baseline demographics were similar between the two groups although significantly more patients in the grafalon group received ABO incompatible transplant (15% vs. 4.3%; P = 0.002). Patient survival was similar between the two groups (99% in grafalon vs. 98.8% in thymoglobulin; P = 1.0). Death censored graft survival was also similar (99% in grafalon vs. 100% in thymoglobulin; P = 0.23). Biopsy proven acute rejection (BPAR) was significantly higher in the grafalon group (12.8% vs. 5.1%, P = 0.04). The significance persisted after multivariable regression analysis (P = 0.02). Other outcomes such as infection rate and estimated glomerular filtration rate on last follow up were comparable between the two groups.
CONCLUSIONS: Grafalon (6 mg/kg dose) when used as an induction agent was associated with significantly higher rate of BPARs as compared to thymoglobulin (3 mg/kg dose) although with comparable short-term patient and death censored graft survival, graft function, and infection rates.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
Indian journal of nephrology - 31(2021), 4 vom: 01. Juli, Seite 336-340 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jha, Pranaw Kumar [VerfasserIn] |
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| Links: |
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| Themen: |
Antilymphocyte serum |
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| Anmerkungen: |
Date Revised 27.04.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.4103/ijn.IJN_205_20 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Grafalon® vs. Thymoglobulin® as an Induction Agent in Renal Transplantation - A Retrospective Study |
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| 500 | |a published: Print-Electronic | ||
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| 520 | |a Copyright: © 2020 Indian Journal of Nephrology. | ||
| 520 | |a INTRODUCTION: Antihuman thymocyte immunoglobulin, used as an induction agent in renal transplantation, is of two types - thymoglobulin and grafalon (formerly ATG-Fresenius). In this study, we compared outcomes with these two agents | ||
| 520 | |a METHODS: This was a single-center retrospective study of patients transplanted from January 2017 to October 2019, who received either grafalon or thymoglobulin induction. Grafalon or thymoglobulin was given at 6 and 3 mg/kg, respectively, followed by standard triple immunosuppression of tacrolimus, MMF, and prednisolone | ||
| 520 | |a RESULTS: Median follow up was 22 (3-36) months. Thymoglobulin was given to 255 patients, whereas 78 patients received grafalon. Baseline demographics were similar between the two groups although significantly more patients in the grafalon group received ABO incompatible transplant (15% vs. 4.3%; P = 0.002). Patient survival was similar between the two groups (99% in grafalon vs. 98.8% in thymoglobulin; P = 1.0). Death censored graft survival was also similar (99% in grafalon vs. 100% in thymoglobulin; P = 0.23). Biopsy proven acute rejection (BPAR) was significantly higher in the grafalon group (12.8% vs. 5.1%, P = 0.04). The significance persisted after multivariable regression analysis (P = 0.02). Other outcomes such as infection rate and estimated glomerular filtration rate on last follow up were comparable between the two groups | ||
| 520 | |a CONCLUSIONS: Grafalon (6 mg/kg dose) when used as an induction agent was associated with significantly higher rate of BPARs as compared to thymoglobulin (3 mg/kg dose) although with comparable short-term patient and death censored graft survival, graft function, and infection rates | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antilymphocyte serum | |
| 650 | 4 | |a India | |
| 650 | 4 | |a kidney transplantation | |
| 650 | 4 | |a rabbit | |
| 650 | 4 | |a thymoglobulin | |
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| 700 | 1 | |a Nandwani, Ashish |e verfasserin |4 aut | |
| 700 | 1 | |a Jain, Manish |e verfasserin |4 aut | |
| 700 | 1 | |a Bansal, Dinesh |e verfasserin |4 aut | |
| 700 | 1 | |a Yadav, Dinesh Kumar |e verfasserin |4 aut | |
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| 700 | 1 | |a Mahapatra, Amit Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Sodhi, Puneet |e verfasserin |4 aut | |
| 700 | 1 | |a Kher, Vijay |e verfasserin |4 aut | |
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