Grafalon® vs. Thymoglobulin® as an induction agent in renal transplantation – A retrospective study
Introduction: Antihuman thymocyte immunoglobulin, used as an induction agent in renal transplantation, is of two types – thymoglobulin and grafalon (formerly ATG-Fresenius). In this study, we compared outcomes with these two agents. Methods: This was a single-center retrospective study of patients t...
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doaj-581e8e5577644040b9ab307128dcb7b72021-10-02T17:41:43ZengWolters Kluwer Medknow PublicationsIndian Journal of Nephrology0971-40651998-36622021-01-0131433634010.4103/ijn.IJN_205_20Grafalon® vs. Thymoglobulin® as an induction agent in renal transplantation – A retrospective studyPranaw Kumar JhaAbhyudaysingh RanaAjay KherShyam Bihari BansalSidharth SethiAshish NandwaniManish JainDinesh BansalDinesh Kumar YadavAshwini GaddeAmit Kumar MahapatraPuneet SodhiVijay KherIntroduction: Antihuman thymocyte immunoglobulin, used as an induction agent in renal transplantation, is of two types – thymoglobulin and grafalon (formerly ATG-Fresenius). In this study, we compared outcomes with these two agents. Methods: This was a single-center retrospective study of patients transplanted from January 2017 to October 2019, who received either grafalon or thymoglobulin induction. Grafalon or thymoglobulin was given at 6 and 3 mg/kg, respectively, followed by standard triple immunosuppression of tacrolimus, MMF, and prednisolone. Results: Median follow up was 22 (3–36) months. Thymoglobulin was given to 255 patients, whereas 78 patients received grafalon. Baseline demographics were similar between the two groups although significantly more patients in the grafalon group received ABO incompatible transplant (15% vs. 4.3%; P = 0.002). Patient survival was similar between the two groups (99% in grafalon vs. 98.8% in thymoglobulin; P = 1.0). Death censored graft survival was also similar (99% in grafalon vs. 100% in thymoglobulin; P = 0.23). Biopsy proven acute rejection (BPAR) was significantly higher in the grafalon group (12.8% vs. 5.1%, P = 0.04). The significance persisted after multivariable regression analysis (P = 0.02). Other outcomes such as infection rate and estimated glomerular filtration rate on last follow up were comparable between the two groups. Conclusions: Grafalon (6 mg/kg dose) when used as an induction agent was associated with significantly higher rate of BPARs as compared to thymoglobulin (3 mg/kg dose) although with comparable short-term patient and death censored graft survival, graft function, and infection rates.http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2021;volume=31;issue=4;spage=336;epage=340;aulast=Jhaantilymphocyte serumindiakidney transplantationrabbitthymoglobulin |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pranaw Kumar Jha Abhyudaysingh Rana Ajay Kher Shyam Bihari Bansal Sidharth Sethi Ashish Nandwani Manish Jain Dinesh Bansal Dinesh Kumar Yadav Ashwini Gadde Amit Kumar Mahapatra Puneet Sodhi Vijay Kher |
spellingShingle |
Pranaw Kumar Jha Abhyudaysingh Rana Ajay Kher Shyam Bihari Bansal Sidharth Sethi Ashish Nandwani Manish Jain Dinesh Bansal Dinesh Kumar Yadav Ashwini Gadde Amit Kumar Mahapatra Puneet Sodhi Vijay Kher Grafalon® vs. Thymoglobulin® as an induction agent in renal transplantation – A retrospective study Indian Journal of Nephrology antilymphocyte serum india kidney transplantation rabbit thymoglobulin |
author_facet |
Pranaw Kumar Jha Abhyudaysingh Rana Ajay Kher Shyam Bihari Bansal Sidharth Sethi Ashish Nandwani Manish Jain Dinesh Bansal Dinesh Kumar Yadav Ashwini Gadde Amit Kumar Mahapatra Puneet Sodhi Vijay Kher |
author_sort |
Pranaw Kumar Jha |
title |
Grafalon® vs. Thymoglobulin® as an induction agent in renal transplantation – A retrospective study |
title_short |
Grafalon® vs. Thymoglobulin® as an induction agent in renal transplantation – A retrospective study |
title_full |
Grafalon® vs. Thymoglobulin® as an induction agent in renal transplantation – A retrospective study |
title_fullStr |
Grafalon® vs. Thymoglobulin® as an induction agent in renal transplantation – A retrospective study |
title_full_unstemmed |
Grafalon® vs. Thymoglobulin® as an induction agent in renal transplantation – A retrospective study |
title_sort |
grafalon® vs. thymoglobulin® as an induction agent in renal transplantation – a retrospective study |
publisher |
Wolters Kluwer Medknow Publications |
series |
Indian Journal of Nephrology |
issn |
0971-4065 1998-3662 |
publishDate |
2021-01-01 |
description |
Introduction: Antihuman thymocyte immunoglobulin, used as an induction agent in renal transplantation, is of two types – thymoglobulin and grafalon (formerly ATG-Fresenius). In this study, we compared outcomes with these two agents. Methods: This was a single-center retrospective study of patients transplanted from January 2017 to October 2019, who received either grafalon or thymoglobulin induction. Grafalon or thymoglobulin was given at 6 and 3 mg/kg, respectively, followed by standard triple immunosuppression of tacrolimus, MMF, and prednisolone. Results: Median follow up was 22 (3–36) months. Thymoglobulin was given to 255 patients, whereas 78 patients received grafalon. Baseline demographics were similar between the two groups although significantly more patients in the grafalon group received ABO incompatible transplant (15% vs. 4.3%; P = 0.002). Patient survival was similar between the two groups (99% in grafalon vs. 98.8% in thymoglobulin; P = 1.0). Death censored graft survival was also similar (99% in grafalon vs. 100% in thymoglobulin; P = 0.23). Biopsy proven acute rejection (BPAR) was significantly higher in the grafalon group (12.8% vs. 5.1%, P = 0.04). The significance persisted after multivariable regression analysis (P = 0.02). Other outcomes such as infection rate and estimated glomerular filtration rate on last follow up were comparable between the two groups. Conclusions: Grafalon (6 mg/kg dose) when used as an induction agent was associated with significantly higher rate of BPARs as compared to thymoglobulin (3 mg/kg dose) although with comparable short-term patient and death censored graft survival, graft function, and infection rates. |
topic |
antilymphocyte serum india kidney transplantation rabbit thymoglobulin |
url |
http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2021;volume=31;issue=4;spage=336;epage=340;aulast=Jha |
work_keys_str_mv |
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