Tarique Karim Sabah1, Usman Khalid2, Mohamed Adel Ilham3, Elijah Ablorsu4, Laszlo Szabo5, Sian Griffin6, Rafael Chavez7, Argiris Asderakis8. 1. Cardiff Transplant Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom. Electronic address: Tarique.sabah@wales.nhs.uk. 2. Cardiff Transplant Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom. Electronic address: Usman.khalid@doctors.org.uk. 3. Cardiff Transplant Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom. Electronic address: Adel.ilham@wales.nhs.uk. 4. Cardiff Transplant Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom. Electronic address: Elijah.ablorsu@wales.nhs.uk. 5. Cardiff Transplant Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom. Electronic address: Laszlo.szabo@wales.nhs.uk. 6. Cardiff Transplant Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom. Electronic address: sian.griffin2@wales.nhs.uk. 7. Cardiff Transplant Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom. Electronic address: Rafael.chavez@wales.nhs.uk. 8. Cardiff Transplant Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom. Electronic address: Argiris.asderakis@wales.nhs.uk.
Abstract
AIM: We aimed to analyse the efficacy of the Thymoglobulin dose used for induction in controlled DCD kidneys, and its initial impact on blood cell and CD3 count, as predictors of efficacy. METHODS: 140 DCD patients who received ATG induction, were analysed. Intended dose was 1.25 mg/kg/day over 5 days, rounded to nearest 25 mg and not exceeding 125 mg/dose. Outcomes included the total dose in relation with rejection, DGF, graft survival, eGFR. The cell count response to ATG was assessed as predictors of outcome. RESULTS: Graft survival, was 96.2%, 92.4%, 85% at 1, 3 and 5 years. Rejection was 7% at 1 year and associated with eGFR at 3 (p = 0.003) and 5 years. ATG dose was not predictive of rejection but was associated with the day5 leucocyte and lymphocyte count (p < 0.001) and negatively with DGF (p = 0.05). In 31 patients day3 CD3 count was available and it was associated with rejection (p = 0.002), less DGF (p = 0.09), and 3 years eGFR (p = 0.01). CONCLUSION: Thymoglobulin provides excellent results in DCD kidneys that do not significantly differ with small dose variations. In higher doses it reduces DGF. Lymphocytes and CD3 count, may be useful surrogate markers of efficacy and outcome. Crown
AIM: We aimed to analyse the efficacy of the Thymoglobulin dose used for induction in controlled DCD kidneys, and its initial impact on blood cell and CD3 count, as predictors of efficacy. METHODS: 140 DCD patients who received ATG induction, were analysed. Intended dose was 1.25 mg/kg/day over 5 days, rounded to nearest 25 mg and not exceeding 125 mg/dose. Outcomes included the total dose in relation with rejection, DGF, graft survival, eGFR. The cell count response to ATG was assessed as predictors of outcome. RESULTS: Graft survival, was 96.2%, 92.4%, 85% at 1, 3 and 5 years. Rejection was 7% at 1 year and associated with eGFR at 3 (p = 0.003) and 5 years. ATG dose was not predictive of rejection but was associated with the day5 leucocyte and lymphocyte count (p < 0.001) and negatively with DGF (p = 0.05). In 31 patients day3 CD3 count was available and it was associated with rejection (p = 0.002), less DGF (p = 0.09), and 3 years eGFR (p = 0.01). CONCLUSION: Thymoglobulin provides excellent results in DCD kidneys that do not significantly differ with small dose variations. In higher doses it reduces DGF. Lymphocytes and CD3 count, may be useful surrogate markers of efficacy and outcome. Crown
Authors: Pasquale Viola; Vincenzo Marcelli; Domenico Sculco; Davide Pisani; Alfredo Caglioti; Filippo Ricciardiello; Alfonso Scarpa; Alessia Astorina; Giuseppe Tortoriello; Luca Gallelli; Giovambattista De Sarro; Giuseppe Chiarella Journal: Int J Environ Res Public Health Date: 2022-02-16 Impact factor: 3.390
Authors: Argiris Asderakis; Tarique K Sabah; William J Watkins; Usman Khalid; Laszlo Szabo; Michael R Stephens; Sian Griffin; Rafael Chavez Journal: Kidney Int Rep Date: 2022-01-14