Clinical trial of low-dose rabbit anti-human thymocyte globulin for induction therapy of kidney transplantation in children
10.3760/cma.j.cn421203-20221010-00253
- VernacularTitle:低剂量兔抗人胸腺细胞免疫球蛋白用于儿童肾移植诱导治疗的临床研究
- Author:
Luyu ZHANG
1
;
Di ZHANG
;
Yonghua FENG
;
Chenghao FENG
;
Zhigang WANG
;
Jinfeng LI
;
Lei LIU
;
Hongchang XIE
;
Guiwen FENG
;
Wenjun SHANG
Author Information
1. 郑州大学第一附属医院肾移植科，郑州 450052
- Keywords:
Child;
Kidney transplantation;
Acute rejection;
Rabbit anti-human thymocyte globulin;
Low dose;
Immune induction
- From:
Chinese Journal of Organ Transplantation
2023;44(2):81-86
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of low-dose rabbit anti-human thymocyte globulin (rATG) for induction therapy of kidney transplantation (KT) in children.Methods:From October 2018 to May 2021, clinical data were reviewed retrospectively for 77 pediatric KT recipients on a low-dose rATG induction protocol.Recipient/graft survival rate, renal function recovery, acute rejection (AR) and adverse reactions were observed at 1 year post-operation.The postoperative changes of renal function were examined by Friedman’s test; According to the preoperative baseline data, Pearson’s Chi-square or Fisher's exact test was utilized for examining the influencing factors of postoperative AR.Results:A total of 16(20.78%) recipients had AR within the first 6 months post-operation.The incidence of delayed graft function (DGF) was 14.29%(11/77); The incidence of severe infection post-transplantation 18.18%(14/77), the infection rate of BK virus 25.97%(20/77) and the incidence of neutropenia 32.47%(25/77).The recipient/graft survival rate at 1 year post-operation was 97.40%(75/77) and 94.81%(73/77) respectively.Chi-square test indicated that the incidence of postoperative infection in children with body weight ≤30 kg and height ≤138 cm was 28.95%(11/38) and 27.50%(11/40) respectively, Both were higher than 7.69%(3/39) and 8.11%(3/37) of children with body weight >30 kg and height>138 cm.The difference between groups was statistically significant ( P=0.016 and 0.028). Conclusions:Low-dose rATG is generally excellent in preventing AR in pediatric KT recipients.And the risk of related AR may be lower.The infection rate of recipients with decent preoperative development is low.
