Thymoglobulin Induction Dosing Strategies in a Low-Risk Kidney Transplant Population : Three or Four Days?

Abstract EN

The optimal dose and duration of rabbit antithymocyte globulin (rATG) induction has not been defined.

Methods.

We compared the safety and efficacy of 2 dosing strategies, rATG 1.5 mg/kg for 4 days (n=59) versus 2 mg/kg for 3 days (n=59), in a retrospective, cohort study.

Results.

Two-year rejection-free survival was 95% in each group (P=.983).

Renal function and infection rates were similar.

The incidence of leucopenia was similar, although the 2 mg/kg group was more likely to be thrombocytopenic on day 2 (4% versus 28%, P=.04).

Length of stay tended to be longer for the 1.5 mg/kg group (6.0±3.7 versus 5.1±1.9 days P=.104).

A cost savings of $920 per patient for rATG were seen in the 2 mg/kg group (P=.122).

Conclusions.

Shorter, more intense dosing of rATG is safe and effective.

The 3-day dose strategy resulted in a clinically shorter length of stay and may result in cost savings.