Literature DB >> 24009926

Adding thymoglobuline to the conventional immunosuppressant regimen in kidney transplantation: A cost-benefit analysis.

Farshid Oliaei1, Roghayeh Akbari, Ali Mohammad Ghazi Mirsaeid.   

Abstract

BACKGROUND: Thymoglobuline (TG), is used for both induction and rejection therapy in kidney transplantation (TX). This study was conducted to compare between adding TG or not to the conventional drugs to evaluate the rate of rejections, infections and costs.
METHODS: In two groups of patients, each of 45 cases; group A received conventional drugs (cyclosporine, mycophenolate and prednisolone) and in group B, TG was added; both groups were then compared. TG was administered for 5 doses (1.5 mg/kg/d for the first 3 days and 1 mg/kg/d for the last 2 days. Suspicious signs of rejection (fever, graft tenderness, graft enlargement and increase in length and depth), creatinine rise, diethylene triamine penta-acetic acid scan (DTPA) results and urinary tract infections (UTI) with counts > 10(5) CFU/ml were recorded. The duration of the first hospitalization, the CMV incidence of infection in the first 6 months and their costs were finally compared.
RESULTS: There was no difference for age, duration of hospitalization and CMV infection between the two groups. UTI occurred more frequently in TG group (p=0.049). Creatinine rise, suspicious signs of rejection occurred more frequently in TG group (p<0.05). Creatinine rise and suspicious signs of rejection occurred more frequently in conventional group (p=0.020, p<0.000, respectively). The need for additional steroid pulses was more frequent in conventional group (p<0.000). The total costs of TG, ganciclovir, antibiotics and steroid pulses in both groups were similar.
CONCLUSION: The results show that the posttransplantation problems (signs of rejection, rise of creatinine, graft losses and delayed graft function) occurred rarely in TG group. The incidence of infection and the cost of both regimens were similar. We strongly recommend this protocol as induction therapy.

Entities:  

Keywords:  Anti rejection therapy; Cost & cost analysis; Immunosuppression; Kidney transplantation

Year:  2012        PMID: 24009926      PMCID: PMC3755858     

Source DB:  PubMed          Journal:  Caspian J Intern Med        ISSN: 2008-6164


  10 in total

1.  Induction versus noninduction in renal transplant recipients with tacrolimus-based immunosuppression.

Authors:  G Mourad; V Garrigue; J P Squifflet; T Besse; F Berthoux; E Alamartine; D Durand; L Rostaing; P Lang; C Baron; D Glotz; C Antoine; P Vialtel; T Romanet; Y Lebranchu; A Al Najjar; C Hiesse; L Potaux; P Merville; J L Touraine; N Lefrancois; M Kessler; E Renoult; C Pouteil-Noble; R Cahen; C Legendre; J Bedrossian; P Le Pogamp; J Rivalan; M Olmer; R Purgus; F Mignon; B Viron; B Charpentier
Journal:  Transplantation       Date:  2001-09-27       Impact factor: 4.939

2.  Thymoglobulin induction is safe and effective in live-donor renal transplantation: a single center experience.

Authors:  Karen L Hardinger; Mark A Schnitzler; Matthew J Koch; Emily Labile; Paula M Stirnemann; Brent Miller; Decha Enkvetchakul; Daniel C Brennan
Journal:  Transplantation       Date:  2006-05-15       Impact factor: 4.939

3.  A three-arm study comparing immediate tacrolimus therapy with antithymocyte globulin induction therapy followed by tacrolimus or cyclosporine A in adult renal transplant recipients.

Authors:  Bernard Charpentier; Lionel Rostaing; Francois Berthoux; Philippe Lang; Giovanni Civati; Jean-Louis Touraine; Jean-Paul Squifflet; Paul Vialtel; Daniel Abramowicz; Georges Mourad; Philippe Wolf; Elisabeth Cassuto; Bruno Moulin; Gerard Rifle; André Pruna; Pierre Merville; Françoise Mignon; Christophe Legendre; Patrick Le Pogamp; Yvon Lebranchu; Olivier Toupance; Bruno Hurault De Ligny; Guy Touchard; Michel Olmer; Raj Purgus; Claire Pouteil-Noble; Denis Glotz; Bernard Bourbigot; Michel Leski; Jean-Pierre Wauters; Michèle Kessler
Journal:  Transplantation       Date:  2003-03-27       Impact factor: 4.939

4.  Safety, efficacy, and cost analysis of thymoglobulin induction therapy with intermittent dosing based on CD3+ lymphocyte counts in kidney and kidney-pancreas transplant recipients.

Authors:  V Ram Peddi; Margaret Bryant; Prabir Roy-Chaudhury; E Steve Woodle; M Roy First
Journal:  Transplantation       Date:  2002-05-15       Impact factor: 4.939

Review 5.  Thymoglobulin and ischemia reperfusion injury in kidney and liver transplantation.

Authors:  A Mehrabi; Zh A Mood; M Sadeghi; B M Schmied; S A Müller; Th Welsch; G Kuttymuratov; M N Wente; J Weitz; M Zeier; Ch Morath; C Riediger; P Schemmer; J Encke; M W Büchler; J Schmidt
Journal:  Nephrol Dial Transplant       Date:  2007-09       Impact factor: 5.992

6.  Induction therapy by anti-thymocyte globulin (rabbit) in renal transplantation: a 1-yr follow-up of safety and efficacy.

Authors:  Matthias Büchler; Bruno Hurault de Ligny; Corinne Madec; Yvon Lebranchu
Journal:  Clin Transplant       Date:  2003-12       Impact factor: 2.863

7.  Thymoglobulin and rate of infectious complications after transplantation.

Authors:  P Clesca; M Dirlando; S-I Park; R García; E Ferraz; P G Pinheiro-Machado; L Kushnaroff; H Tedesco-Silva; J O Medina-Pestana
Journal:  Transplant Proc       Date:  2007-03       Impact factor: 1.066

8.  Sirolimus versus cyclosporine in kidney recipients receiving thymoglobulin, mycophenolate mofetil and a 6-month course of steroids.

Authors:  M Büchler; S Caillard; S Barbier; E Thervet; O Toupance; H Mazouz; B Hurault de Ligny; Y Le Meur; A Thierry; F Villemain; A-E Heng; B Moulin; M P Morin; C Noël; Y Lebranchu
Journal:  Am J Transplant       Date:  2007-09-14       Impact factor: 8.086

9.  Thymoglobulin induction dosing strategies in a low-risk kidney transplant population: three or four days?

Authors:  Karen L Hardinger; Rafia S Rasu; Rebecca Skelton; Brent W Miller; Daniel C Brennan
Journal:  J Transplant       Date:  2010-11-07

Review 10.  Thymoglobulin--new approaches to optimal outcomes.

Authors:  Andreea Delia Moicean; Anca Maria Popp; Ioanel Sinescu
Journal:  J Med Life       Date:  2009 Jul-Sep
  10 in total
  4 in total

1.  Cost-Effectiveness of Antibody-Based Induction Therapy in Deceased Donor Kidney Transplantation in the United States.

Authors:  Zahra Gharibi; Mehmet U S Ayvaci; Michael Hahsler; Tracy Giacoma; Robert S Gaston; Bekir Tanriover
Journal:  Transplantation       Date:  2017-06       Impact factor: 4.939

2.  Identifying Important Risk Factors for Survival in Kidney Graft Failure Patients Using Random Survival Forests.

Authors:  Omid Hamidi; Jalal Poorolajal; Maryam Farhadian; Leili Tapak
Journal:  Iran J Public Health       Date:  2016-01       Impact factor: 1.429

Review 3.  Alemtuzumab versus antithymocyte globulin induction therapies in kidney transplantation patients: A systematic review and meta-analysis of randomized controlled trials.

Authors:  Jianming Zheng; Wenli Song
Journal:  Medicine (Baltimore)       Date:  2017-07       Impact factor: 1.889

4.  Comparison of the Effect of Alemtuzumab versus Standard Immune Induction on Early Kidney Allograft Function in Shiraz Transplant Center.

Authors:  A Khalafi-Nezhad; M M Sagheb; F Amirmoezi; Z Jowkar; A R Dehghanian
Journal:  Int J Organ Transplant Med       Date:  2015-11-01
  4 in total

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