Comparison of Thymoglobulin and Grafalon as Induction Agents in Renal Transplantation: A Prospective Study.

Abstract

BACKGROUND:

Induction immunosuppression is used to reduce the incidence of acute rejection and prevent delayed graft function. The 2 rabbit anti-thymocyte globulins- thymoglobulin and Grafalon (ATG Fresenius) have been commonly used for induction immunosuppression and treatment of acute rejection in solid organ transplantation. There are very few studies comparing the efficacy and side effects of both the anti-thymocyte globulins therefore this prospective study comparing the 2 types of anti-thymocyte globulins would be of clinical interest.

PATIENTS AND METHODS:

This prospective single center study was conducted at Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India from April 2019 to June 2020. Sixty-two ABO-compatible renal transplant recipients were included in the study. They were divided in 2 groups of 31 patients each. One group received thymoglobulin (3 mg/kg) and the second group received Grafalon (6 mg/kg). All patients were followed up for 12 months and the 2 groups were compared for incidence of rejections, infections, graft function, patient survival, and graft survival.

RESULTS:

There was no significant difference in the incidence of rejections, infective episodes, graft function, posttransplant diabetes mellitus, graft survival and patient survival in thymoglobulin or Grafalon groups. The hematological parameters were similar in both groups at 7 days, 1 month, and 6 months of follow-up. The absolute lymphocyte count was significantly lower in the thymoglobulin group at 12 months posttransplant.

CONCLUSIONS:

Thymoglobulin and Grafalon were found to be equivalent in terms of safety and efficacy in short term, with no difference in rejections, infections, graft survival, or patient survival.

• Authors: Sharmila Thukral, Ratnesh Rokde, Deepak Shankar Ray
• Journal: Transplantation proceedings (Transplant Proc) Vol. 54 Issue 8 Pg. 2133-2139 (Oct 2022) ISSN: 1873-2623 [Electronic] United States
• PMID: 36116944 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• thymoglobulin
• Antilymphocyte Serum
• Immunosuppressive Agents

Topics

• Antilymphocyte Serum (adverse effects)
• Kidney Transplantation (adverse effects)
• Prospective Studies
• Graft Rejection (epidemiology)
• Immunosuppressive Agents (adverse effects)
• Graft Survival