Mansoura ATG and steroid resistant rejection

ABSTRACT

ATG is one of the most effective therapeutic agents in the treatment of acute renal allogrqft rejection, especially when the episode is resistant to steroids. Anti thymocyte globulin [ATG] is a hyperirnmune serum produced in rabbits against purified human thymus cells. Fifteen patches of ATG were prepared locally in our lab. Antibody production was done by injection of purified human thymus cells into about 10-12 rabbits/patch. Adsorption, fractionation and purification of rabbit serum, antibody assays, and quality control tests were done. Our ATG was utilized in 20 patients suffering from sterioid resistant rejection [SRR]. Monitoring of the drug by T cell subsets analysis and Anti ATG antibodies revealed depletion of the total T lymphocytes especially in the early doses beside absence of anti ATG antibodies without any side effects of the preparation on the other haematologic series. Regarding the clinical efficacy of our ATG in reversing SRR, 80% of cases respond completely while partial response was noted in 10% and another 10% showed failure. In conclusion our ATG is as effective as other ATG in saving renal transplantation otherwise the graft will be lost