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Effects of Ideal Versus Total Body Weight Dosage of Rabbit Antithymocyte Globulin on Outcomes of Kidney Transplant Patients With High Immunologic Risk.

Publication ,  Journal Article
Vacha, M; Gommer, J; Rege, A; Sanoff, S; Sudan, D; Harris, M
Published in: Exp Clin Transplant
October 2016

OBJECTIVES: The optimal dose of rabbit antithymocyte globulin induction therapy in kidney transplant recipients with high immunologic risk lacks consensus. The purpose of this study was to evaluate the effect of using ideal body weight rather than total body weight for the weight-based dose calculations in this patient population. MATERIALS AND METHODS: Data were retrospectively collected on 89 adult patients who received rabbit antithymocyte globulin induction therapy for high immunologic risk kidney transplant. Hospital protocol changed from the use of cumulative rabbit antithymocyte globulin doses of 7.5 mg/kg total body weight to 7.5 mg/kg ideal body weight in 2009. Patients were separated into 2 cohorts based on the amount of rabbit antithymocyte globulin (in mg/kg total body weight) received. Rate of biopsy-proven acute rejection, patient survival, and allograft function were evaluated at 90 days and 1 year after transplant. Cost of induction therapy was also evaluated. RESULTS: Baseline demographics were predominantly similar between the 2 cohorts. No significant difference in maintenance immunosuppression was identified. Rates of biopsy-proven acute rejection at 90 days and 1 year were similar between ideal and total body weight cohorts (4.2% vs 0% at 90 days, P = .5; 8.7% vs 0% at 1 year, P = .13). Patient survival and allograft function were also similar. Median cost of rabbit antithymocyte globulin induction therapy per patient was lower in the ideal body weight cohort, but this difference was not statistically significant ($17 542 vs $19 934; P = .3). CONCLUSIONS: Our results suggest that use of ideal body weight for dose calculations of rabbit antithymocyte globulin induction therapy in high immunologic risk kidney transplant recipients at 7.5 mg/kg results in low rates of acute rejection with a safety profile similar to that shown with a total body weight dosage. Use of ideal body weight for lower cumulative doses may still need further evaluation in this patient population.

Duke Scholars

Published In

Exp Clin Transplant

DOI

EISSN

2146-8427

Publication Date

October 2016

Volume

14

Issue

5

Start / End Page

511 / 517

Location

Turkey

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Surgery
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • North Carolina
  • Models, Biological
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Vacha, M., Gommer, J., Rege, A., Sanoff, S., Sudan, D., & Harris, M. (2016). Effects of Ideal Versus Total Body Weight Dosage of Rabbit Antithymocyte Globulin on Outcomes of Kidney Transplant Patients With High Immunologic Risk. Exp Clin Transplant, 14(5), 511–517. https://doi.org/10.6002/ect.2015.0197
Vacha, Mary, Jennifer Gommer, Aparna Rege, Scott Sanoff, Debra Sudan, and Matt Harris. “Effects of Ideal Versus Total Body Weight Dosage of Rabbit Antithymocyte Globulin on Outcomes of Kidney Transplant Patients With High Immunologic Risk.Exp Clin Transplant 14, no. 5 (October 2016): 511–17. https://doi.org/10.6002/ect.2015.0197.
Vacha M, Gommer J, Rege A, Sanoff S, Sudan D, Harris M. Effects of Ideal Versus Total Body Weight Dosage of Rabbit Antithymocyte Globulin on Outcomes of Kidney Transplant Patients With High Immunologic Risk. Exp Clin Transplant. 2016 Oct;14(5):511–7.
Vacha, Mary, et al. “Effects of Ideal Versus Total Body Weight Dosage of Rabbit Antithymocyte Globulin on Outcomes of Kidney Transplant Patients With High Immunologic Risk.Exp Clin Transplant, vol. 14, no. 5, Oct. 2016, pp. 511–17. Pubmed, doi:10.6002/ect.2015.0197.
Vacha M, Gommer J, Rege A, Sanoff S, Sudan D, Harris M. Effects of Ideal Versus Total Body Weight Dosage of Rabbit Antithymocyte Globulin on Outcomes of Kidney Transplant Patients With High Immunologic Risk. Exp Clin Transplant. 2016 Oct;14(5):511–517.

Published In

Exp Clin Transplant

DOI

EISSN

2146-8427

Publication Date

October 2016

Volume

14

Issue

5

Start / End Page

511 / 517

Location

Turkey

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Surgery
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • North Carolina
  • Models, Biological
  • Middle Aged
  • Male