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Rabbit anti-thymocyte globulin induction therapy does not prolong survival after lung transplantation.

Publication ,  Journal Article
Hartwig, MG; Snyder, LD; Appel, JZ; Cantu, E; Lin, SS; Palmer, SM; Davis, RD
Published in: J Heart Lung Transplant
May 2008

BACKGROUND: Lung transplant survival is limited by the development of bronchiolitis obliterans syndrome (BOS). The strongest risk factor for BOS is acute rejection (AR). We have previously shown that rabbit anti-thymocyte globulin (RATG) induction therapy is associated with a decrease in early AR. Thus, we hypothesized that RATG induction would translate to reduced BOS and improved long-term graft survival. METHODS: Forty-four lung recipients were prospectively randomized to receive conventional immunosuppression with RATG induction (RATG group) or conventional immunosuppression alone (control group). End-points included graft survival, early and total acute rejection, BOS and treatment complications. RESULTS: There was no difference in graft survival between the groups at 8 years (RATG: 36%; control: 23%; p = 0.48). The RATG group had fewer early rejections compared with the control group (5% vs 41%; p = 0.01). However, the overall rejection incidence did not differ (RATG: 62%; control: 68%; p = 0.52). There was a trend toward a delay in BOS onset among RATG subjects compared with control subjects (2,376 days vs 1,108 days; log rank, p = 0.15). There was no difference in the incidence of infections, but the RATG group had a higher rate of malignancies. CONCLUSIONS: Our results suggest that alternative approaches to anti-thymocyte induction should be pursued to reduce BOS and prolong allograft survival.

Duke Scholars

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

May 2008

Volume

27

Issue

5

Start / End Page

547 / 553

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Surgery
  • Risk Factors
  • Rabbits
  • Middle Aged
  • Male
  • Lung Transplantation
  • Immunosuppressive Agents
  • Humans
 

Citation

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Hartwig, M. G., Snyder, L. D., Appel, J. Z., Cantu, E., Lin, S. S., Palmer, S. M., & Davis, R. D. (2008). Rabbit anti-thymocyte globulin induction therapy does not prolong survival after lung transplantation. J Heart Lung Transplant, 27(5), 547–553. https://doi.org/10.1016/j.healun.2008.01.022
Hartwig, Matthew G., Laurie D. Snyder, James Z. Appel, Ed Cantu, Shu S. Lin, Scott M. Palmer, and R Duane Davis. “Rabbit anti-thymocyte globulin induction therapy does not prolong survival after lung transplantation.J Heart Lung Transplant 27, no. 5 (May 2008): 547–53. https://doi.org/10.1016/j.healun.2008.01.022.
Hartwig MG, Snyder LD, Appel JZ, Cantu E, Lin SS, Palmer SM, et al. Rabbit anti-thymocyte globulin induction therapy does not prolong survival after lung transplantation. J Heart Lung Transplant. 2008 May;27(5):547–53.
Hartwig, Matthew G., et al. “Rabbit anti-thymocyte globulin induction therapy does not prolong survival after lung transplantation.J Heart Lung Transplant, vol. 27, no. 5, May 2008, pp. 547–53. Pubmed, doi:10.1016/j.healun.2008.01.022.
Hartwig MG, Snyder LD, Appel JZ, Cantu E, Lin SS, Palmer SM, Davis RD. Rabbit anti-thymocyte globulin induction therapy does not prolong survival after lung transplantation. J Heart Lung Transplant. 2008 May;27(5):547–553.

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

May 2008

Volume

27

Issue

5

Start / End Page

547 / 553

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Surgery
  • Risk Factors
  • Rabbits
  • Middle Aged
  • Male
  • Lung Transplantation
  • Immunosuppressive Agents
  • Humans