13,823 results match your criteria antithymocyte globulin

Induction Therapy With Antithymocyte Globulin and Delayed Calcineurin Inhibitor Initiation for Renal Protection in Liver Transplantation: A Multicenter Randomized Controlled Phase II-B Trial.

Transplantation 2021 Jul 27. Epub 2021 Jul 27.

Digestive Disease and Surgery Institute, Transplant Center, Cleveland Clinic, Cleveland, OH. Division of Transplantation, University of Cincinnati College of Medicine, Cincinnati, OH. Transplant Center, Cleveland Clinic Weston, Weston, FL. Division of Transplantation Surgery, Medical College of Wisconsin, Milwaukee, WI. Transplantation Institute, University of Chicago Medicine, Chicago, IL.

Background: Calcineurin inhibitor (CNI) based immunosuppression in liver transplantation (LTx) is associated with acute and chronic deterioration of kidney function. Delaying CNI initiation by using induction rabbit anti-thymocyte globulin (rATG) may provide kidneys with adequate time to recover from a perioperative insult reducing the risk of early post-LTx renal deterioration.

Methods: This was an open-label, multicenter, randomized controlled clinical trial comparing use of induction rATG with delayed CNI initiation (day-10) against upfront CNI commencement (SOC; standard of care) in those patients deemed at standard risk of postoperative renal dysfunction following LTx. Read More

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Evolution of Immune Checkpoint Blockade-Induced Myocarditis Over 2 Years.

JACC Case Rep 2020 Feb 19;2(2):203-209. Epub 2020 Feb 19.

Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama.

Ipilimumab and nivolumab for melanoma induced smoldering myocarditis remitting with steroids. Rechallenge with nivolumab produced steroid-refractory myocarditis confirmed by electron microscopy. Tacrolimus and mycophenolate transiently reduced inflammation, but antithymocyte globulin induced remission. Read More

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February 2020

Antithymocyte globulin is associated with a lower incidence of de novo donor-specific antibody detection in lung transplant recipients: A single-center experience.

Immun Inflamm Dis 2021 Jul 26. Epub 2021 Jul 26.

Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, USA.

Purpose: Induction immunosuppression has improved the long-term outcomes after lung transplant. This is the first report exploring the association of induction immunosuppression with the development of de novo donor-specific human leukocyte antigen (HLA) antibodies (DSA) in lung transplant recipients (LTR).

Methods: Sixty-seven consecutive primary LTR were followed for 3 years posttransplant. Read More

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Relationship Between Antithymocyte Globulin Concentrations and Lymphocyte Sub-Populations in Kidney Transplant Patients.

Clin Pharmacokinet 2021 Jul 22. Epub 2021 Jul 22.

University of Tours, EA4245 T2I, Tours, France.

Background: Rabbit antithymocyte globulins (rATGs) are polyclonal antibodies used to prevent acute cellular rejection in kidney transplantation. Their dosing remains largely empirical and the question of an individualized dose is still unresolved.

Methods: Data from a prospective study in 17 kidney transplant patients were used to develop a model describing the dose-concentration-response relationship of rATG with T-lymphocyte subpopulation counts over time. Read More

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Risk Factors Influencing the Outcomes of Kidney Re-Transplantation.

Ann Transplant 2021 Jul 16;26:e928922. Epub 2021 Jul 16.

Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.

BACKGROUND Our kidney transplant waitlist includes 20% re-transplantations (TX2). Knowing what to expect is a clinical obligation. MATERIAL AND METHODS We compared graft and patient survival of all 162 TX2 patients, transplanted 2000 to 2009, with 162 patients after first transplantation (TX1) matched for age, sex, living/non-living donation, and transplantation date. Read More

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Intestinal Transplantation at a Single Institution in Japan.

Transplant Proc 2021 Jul 12. Epub 2021 Jul 12.

Department of Pediatric Surgery, Tohoku University School of Medicine, Sendai, Japan.

Background: This study aimed to compare the clinical outcomes of intestinal transplantation (ITX) between 2 groups by using medications for induction treatment and assess the utility of the current protocol.

Methods: From 2003 to 2020, 11 patients underwent ITX. Recipients were classified into 2 groups: group IL-2Ra (interleukin-2 receptor antagonist therapy, n = 6) and ATG (rabbit antithymocyte globulin therapy, n = 5). Read More

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Rabbit Antithymocyte Globulin Induction in Heart Transplant Recipients at High Risk for Rejection.

Ochsner J 2021 ;21(2):133-138

Section of Cardiomyopathy and Heart Transplantation, John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA.

Induction with lymphocyte-depleting antibodies may improve allograft outcomes in heart transplant recipients who are at high immunologic risk for rejection. We conducted a single-center retrospective cohort study that compared outcomes between adult patients receiving rabbit antithymocyte globulin (rATG) induction vs no induction from 2011 through 2017. Key exclusion criteria were patients who did not receive tacrolimus and mycophenolate and patients who did not meet high immunologic risk criteria. Read More

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January 2021

Belatacept for Simultaneous Calcineurin Inhibitor and Chronic Corticosteroid Immunosuppression Avoidance.

Clin J Am Soc Nephrol 2021 Jul 7. Epub 2021 Jul 7.

R Alloway, University of Cincinnati College of Medicine, Cincinnati, United States.

Immunosuppressive therapy in kidney transplantation is associated with numerous toxicities. CD28-mediated T cell costimulation blockade using belatacept may reduce long-term nephrotoxicity, compared with calcineurin inhibitor-based immunosuppression. The efficacy and safety of simultaneous calcineurin inhibitor avoidance and rapid steroid withdrawal were tested in a randomized, prospective, multi-center study. Read More

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Immunoguided Discontinuation of Prophylaxis for Cytomegalovirus Disease in Kidney Transplant Recipients Treated with Antithymocyte Globulin: A Randomized Clinical Trial.

Clin Infect Dis 2021 Jun 22. Epub 2021 Jun 22.

Maimónides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofía University Hospital/University of Cordoba (UCO), Cordoba, Spain.

Background: Antiviral prophylaxis is recommended in cytomegalovirus (CMV)-seropositive kidney transplant (KT) recipients receiving antithymocyte globulin (ATG) as induction. An alternative strategy of premature discontinuation of prophylaxis after CMV-specific cell-mediated immunity (CMV-CMI) recovery (immunoguided prevention) has not been studied. The aim of this study was to evaluate whether it is effective and safe to discontinue prophylaxis when CMV-CMI is detected and to continue with preemptive therapy. Read More

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[Optimal selection of alternative donors for allogeneic hematopoietic stem cell transplantation].

Rinsho Ketsueki 2021 ;62(6):593-601

Department of Hematology, Kyoto University Hospital.

A human leukocyte antigen (HLA)-matched related donor is considered as the first donor candidate in case of allogenic hematopoietic stem cell transplantation (allo-HSCT). Given the declining birthrate and aging population in Japan, the number of sibling donors is also decreasing. Hence, candidates other than HLA-matched siblings, named "alternative donors," have attracted increasing attention. Read More

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Post-transplant Cyclophosphamide Versus Thymoglobulin in HLA-Mismatched Unrelated Donor Transplant for Acute Myelogenous Leukemia and Myelodysplastic Syndrome.

Transplant Cell Ther 2021 Jun 23. Epub 2021 Jun 23.

Department of Oncology, Blood and Marrow Stem Cell Transplant Program, Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, Michigan.

Limited information is available on the efficacy of post-transplantation cyclophosphamide (PTcy) or thymoglobulin for graft-versus-host disease (GVHD) prophylaxis in mismatched unrelated donor (MMUD) transplants. We retrospectively compared outcomes of 76 adult patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS) who underwent 7/8 HLA-MMUD transplantation and received either PTcy (50 mg/kg on day 3 and 4) or thymoglobulin (total dose 4.5 mg/kg) for GVHD prophylaxis. Read More

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Predictors and Complications of Post Kidney Transplant Leukopenia.

Prog Transplant 2021 Jun 23:15269248211024614. Epub 2021 Jun 23.

Nova Scotia Health Authority Division of Nephrology, Dalhousie University, Halifax, Nova Scotia, Canada.

Background: Leukopenia occurs frequently following kidney transplantation and is associated with adverse clinical outcomes including increased infectious risk. In this study we sought to characterize the causes and complications of leukopenia following kidney transplantation.

Methods: In a cohort of adult patients (≥18 years) who underwent kidney transplant from Jan 2006-Dec 2017, we used univariable Cox proportional Hazards models to identify predictors of post-transplant leukopenia (WBC < 3500 mm). Read More

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Circulatory follicular helper T lymphocytes associate with lower incidence of CMV infection in kidney transplant recipients.

Am J Transplant 2021 Jun 21. Epub 2021 Jun 21.

Instituto de Investigación Biomédica Hospital 12 de Octubre (imas12), Madrid, Spain.

Primary infection and/or reactivation of cytomegalovirus (CMV) in kidney transplant recipients (KTR) favor rejection and mortality. T follicular helper cells (TFH) could contribute to protection against CMV. Circulatory TFH (cTFH) were studied pretransplant and early posttransplant in 90 CMV seropositive KTR not receiving antithymocyte globulin or antiviral prophylaxis, followed-up for 1 year. Read More

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Heterogeneous Manifestations of Posttransplant Lymphoma in Renal Transplant Recipients: A Case Series.

Transplant Proc 2021 Jun 13;53(5):1519-1527. Epub 2021 Jun 13.

Kidney and Pancreas Transplant Program, Henry Ford Transplant Institute, Detroit, Michigan. Electronic address:

Posttransplant lymphoproliferative disorder (PTLD) occurs in 1% to 3% of adult renal transplant recipients (RTRs). PTLD has a heterogeneous presentation and is often associated with Epstein-Barr virus (EBV) and immunosuppression. We present a descriptive case series of 16 RTRs who demonstrate a variety of PTLD manifestations. Read More

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HLA-DR Mismatch and Black Race Are Associated With Recurrent Autoimmune Hepatitis After Liver Transplantation.

Transplant Direct 2021 Jul 10;7(7):e714. Epub 2021 Jun 10.

Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN.

The predictors of recurrent autoimmune hepatitis (R-AIH) after liver transplantation (LT) are heterogeneous with limited data to guide immunosuppression, with little data on impact of race.

Aims: To describe the incidence, predictors, and outcomes of R-AIH.

Methods: We studied patients undergoing LT for AIH during 2000-2017 at our center. Read More

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Enhanced Immune Reconstitution of γδ T Cells after Allogeneic Stem Cell Transplantation Overcomes the Negative Impact of Pretransplantation Minimal Residual Disease-Positive Status in Patients with Acute Myelogenous Leukemia.

Transplant Cell Ther 2021 Jun 9. Epub 2021 Jun 9.

Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address:

Minimal/measurable residual disease (MRD) before allogeneic stem cell transplantation (allo-SCT) in patients with acute myelogenous leukemia (AML) is a poor risk factor for outcome. γδ T cells represent a unique minority lymphocyte population that is preferentially located in peripheral tissues, can recognize antigens in a non-MHC-restricted manner, and plays a "bridging" role between the innate and adaptive immune systems. In this study, we investigated a potential graft-versus-leukemia effect of γδ T cell reconstitution post-transplantation in AML patients with pretransplantation positive MRD status (MRD). Read More

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Incidence and risk factors of late-onset hemorrhagic cystitis after single umbilical cord blood transplantation with myeloablative conditioning regimen.

Int J Hematol 2021 Jun 12. Epub 2021 Jun 12.

Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Hefei, China.

Objective: To explore the incidence and risk factors of late-onset hemorrhagic cystitis (LOHC) in patients undergoing single umbilical cord blood transplantation for hematological malignancies.

Methods: Clinical data from 234 patients who consecutively underwent single UCBT using a myeloablative conditioning regimen without antithymocyte globulin in our center were retrospectively analyzed.

Results: In total, 64 (27. Read More

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Infection-Related Mortality in Adults and Children Undergoing Allogeneic Hematopoietic Cell Transplantation: An Australian Registry Report.

Transplant Cell Ther 2021 Jun 7. Epub 2021 Jun 7.

National Centre for Infection in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.

Infection-related mortality (IRM) is the most common non-relapse-related cause of death reported after allogeneic hematopoietic cell transplantation (HCT). Information on the incidence and timing of specific infective organisms and the risk factors for IRM is essential to developing prevention strategies. This report provides the first account of IRM in adults and children undergoing HCT in Australia. Read More

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A systematic review and meta-analysis of the safety and efficacy of anti-thymocyte globulin combined with eltrombopag in the treatment of severe aplastic anemia.

Ann Palliat Med 2021 May;10(5):5549-5560

Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Department of Academic Journal, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

Background: When it comes to the treatment of aplastic anemia fever, the Guidelines for Aplastic Anemia regards Anti-thymocyte globulin (ATG) combined with eltrombopag as the standard immunosuppressive treatment plan, and ATG is the main mode to treat severe aplastic anemia. A large number of prospective studies and clinical trials have confirmed the clinical application value of eltrombopag in aplastic anemia. Although ATG combined with eltrombopag brings satisfactory treatment results, the safety of long-term use is still unclear. Read More

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A clinical study of lyophilized intravenous human immunoglobulin containing high-titer cytomegalovirus-neutralizing antibody for the treatment of cytomegalovirus viremia after allogeneic hematopoietic stem cell transplantation.

Ann Palliat Med 2021 May;10(5):5533-5540

State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.

Background: Cytomegalovirus (CMV) infection increases the risk of death after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, some patients do not respond to ganciclovir (GCV) or foscarnet sodium. Lyophilized intravenous human immunoglobulin containing high-titer CMV-neutralizing antibody (CMV-IVIG) is another option to further improve treatment safety and efficacy. Read More

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Disseminated Intravascular Coagulation During Induction Treatment With Rabbit-Derived Antithymocyte Globulin For Kidney Transplant.

Exp Clin Transplant 2021 Jun 3. Epub 2021 Jun 3.

From the Department of Pharmacy Services and Clinical Pharmacy, Michigan Medicine, University of Michigan Health System and University of Michigan College of Pharmacy, Michigan, USA.

Rabbit antithymocyte globulin is a lymphocytedepleting agent commonly used as induction therapy in kidney transplants. Although its use is generally safe and well tolerated, serious side effects can occur. Here, we describe a case of a severe immune complex hypersensitivity reaction with disseminated intravascular coagulation in response to rabbit antithymocyte globulin infusion. Read More

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Surgical Complications After Deceased Donor Renal Transplant.

Exp Clin Transplant 2021 Jun 3. Epub 2021 Jun 3.

From the Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.

Objectives: Deceased donor renal transplant is an accepted treatment for patients with end-stage renal disease. We retrospectively analyzed urological and surgical complications and outcomes in our series.

Material And Methods: Since 2016, we have performed 263 renal transplants at the Gazi University Transplantation Center, Ankara, and 92 of these were from deceased donors. Read More

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A pilot trial of autologous hematopoietic stem cell transplant in neuromyelitis optic spectrum disorder.

Mult Scler Relat Disord 2021 May 4;53:102990. Epub 2021 May 4.

Department of Medicine, University of Calgary.

Background: Autologous hematopoietic stem cell transplantation (AHSCT) has become a standard treatment in multiple sclerosis. The role of AHSCT for neuromyelitis optica spectrum disorder (NMO/NMOSD) is unclear. We studied AHSCT in NMO/NMOSD patients who have failed conventional immunosuppressive therapy. Read More

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Long-term outcomes of sensitized lung transplant recipients after peri-operative desensitization.

Am J Transplant 2021 May 31. Epub 2021 May 31.

Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada.

The Toronto Lung Transplant Program has been using a peri-operative desensitization regimen of plasma exchange, intravenous immune globulin, and antithymocyte globulin in order to accept donor-specific antibody (DSA)-positive lung transplants safely since 2008. There are no long-term data on the impact of this practice on allograft survival or the development of chronic lung allograft dysfunction (CLAD). We extended our prior study to include long-term follow-up of 340 patients who received lung transplants between January 1, 2008 and December 31, 2011. Read More

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The response-guided ATG treatment provides a survival benefit and KPS recovery for patients with steroid refractory acute GVHD: The Nagasaki Transplant Group Experience.

Transpl Immunol 2021 08 28;67:101417. Epub 2021 May 28.

Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan; Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan; Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.

Steroid-refractory acute graft-versus-host disease (SR-aGVHD) is a serious complication that negatively affects the prognosis and quality of life of patients who receive allogeneic hematopoietic stem cell transplantation (allo-HSCT). Antithymocyte globulin (ATG) is one of the second-line treatments for SR-aGVHD. We retrospectively evaluated Karnofsky Performance Status (KPS) recovery and clinical response in 11 patients who received the response-guided low-dose ATG treatment for SR-aGVHD after allo-HSCT using alternative donors. Read More

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A Network Meta-Analysis of Induction Immunosuppression for Simultaneous Pancreas-Kidney Transplant From Randomized Clinical Trials.

Exp Clin Transplant 2021 May;19(5):397-404

From the Department of HPB and Transplant Surgery, The Freeman Hospital, Newcastle upon Tyne, Tyne and Wear; and the Institute of Cellular Medicine, University of Newcastle, Newcastle upon Tyne, Tyne and Wear, United Kingdom.

Objectives: Induction immunosuppression for simultaneous pancreas-kidney transplant has helped reduce graft loss due to early rejection. Both thymoglobulin and interleukin 2 receptor antagonists are the most commonly used induction agents; however, some high-volume centers prefer alemtuzumab.Thisnetwork meta-analysis aimedto compare differentinductionregimens for simultaneouspancreaskidney transplantin terms ofbothpancreas and patient graft survival, as well to assess acute rejection. Read More

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Low-dose antithymocyte globulin plus low-dose posttransplant cyclophosphamide combined with cyclosporine and mycophenolate mofetil for prevention of graft-versus-host disease after HLA-matched unrelated donor peripheral blood stem cell transplantation.

Bone Marrow Transplant 2021 May 25. Epub 2021 May 25.

Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

The standard regimens for graft-versus-host disease (GvHD) prophylaxis in matched unrelated donor (MUD) transplantation were based on antithymocyte globulin (ATG) in combination with calcineurin inhibitors (CNIs). To improve the efficiency of GvHD prophylaxis in MUD peripheral blood stem cell transplantation (MUD-PBSCT), 51 patients with hematological malignancies received a novel regimen for GvHD prophylaxis, which is composed of low dose of ATG (5 mg/kg) plus low-dose posttransplant cyclophosphamide (PTCy, 50 mg/kg) (low-dose ATG/PTCy) combined with cyclosporine A (CsA) and mycophenolate mofetil (MMF). The cumulative incidences (CIs) of grades I-IV and II-IV acute GvHD (aGvHD) were 14. Read More

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A call for transplant stewardship: The need for expanded evidence-based evaluation of induction and biologic-based cost-saving strategies in kidney transplantation and beyond.

Clin Transplant 2021 May 25:e14372. Epub 2021 May 25.

Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Rising expenditures threaten healthcare sustainability. While transplant programs are typically considered profitable, transplant medications are expensive and frequently targeted for cost savings. This review aims to summarize available literature supporting cost-containment strategies used in solid organ transplant. Read More

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Reduced-toxicity conditioning regimen with busulfan, fludarabine, rATG, and 400 cGy TBI in pediatric patients undergoing hematopoietic stem cell transplant for high-risk hematologic malignancies.

Pediatr Blood Cancer 2021 Aug 22;68(8):e29087. Epub 2021 May 22.

Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Background: Myeloablative conditioning regimens decrease the risk of relapse in pediatric patients undergoing allogeneic hematopoietic stem cell transplant (HCT) for hematologic malignancies, but cause significant toxicities PROCEDURE: This prospective study evaluated the use of a reduced-toxicity, myeloablative regimen with dose-adjusted busulfan, fludarabine, antithymocyte globulin and 400 cGy of total body irradiation in 40 patients < 21 years of age undergoing HCT for high-risk leukemias. Busulfan pharmacokinetics were measured to target 4000 μmol*min/day in the first 30 patients; this was increased to 5000 μmol*min/day in the subsequent 10 in efforts to further decrease relapse risk RESULTS: Overall survival at two- and five-years post-HCT was 67% and 51%, respectively. Relapse occurred in 11 patients (28%) at a median of seven months and was the leading cause of death. Read More

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