Safety of Antithymocyte Globulin Use in Kidney Graft Recipients During the COVID-19 Pandemic.
Ann Transplant
; 26: e933001, 2021 Oct 26.
Article
in English
| MEDLINE | ID: covidwho-1485494
ABSTRACT
BACKGROUND There are many safety concerns regarding the use of antithymocyte globulin (ATG) in kidney transplant recipients (KTRs) during the ongoing COVID-19 pandemic. Hereby, we present our recent experience with ATG administration both as induction therapy and as an anti-rejection treatment. MATERIAL AND METHODS We retrospectively analyzed all patients transplanted during the first 12 months of the COVID-19 pandemic who were treated with thymoglobulin. The ATG dosing, lymphocyte number and percentage in blood smear, adverse effects (thrombocytopenia and infectious complications), and kidney graft function up to 12 months and patients' outcomes were analyzed and compared to KTRs who received basiliximab induction. RESULTS During pandemic, a total of 31 patients were treated with ATG and 59 received basiliximab. The median cumulative ATG doses were 275 (175-325) mg in the induction subgroup and 263 (200-275) mg in the anti-rejection treatment subgroup. Mild thrombocytopenia was noted in 7 (22.6%) and 13 (29.5%) patients, respectively. There were more infectious complications among patients treated with ATG as compared with the basiliximab subgroup (32.3 vs 10.2%, P<0.01), but there were similar incidence rates of thrombocytopenia. Kidney graft function up to 12 months after transplant was comparable (1.1 [1.0-1.9] vs 1.1 [1.0-1.4] mg/dl, respectively). CONCLUSIONS 1. ATG use in the induction protocol or as the anti-rejection treatment during the COVID-19 pandemic appears to be safe and the risk of adverse events is acceptable. 2. During the COVID-19 pandemic the necessary use of ATG should not be postponed, especially in KTRs with increased immunologic risk.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Kidney Transplantation
/
COVID-19
/
Immunosuppressive Agents
/
Antilymphocyte Serum
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Ann Transplant
Journal subject:
Transplantation
Year:
2021
Document Type:
Article
Affiliation country:
AOT.933001
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