Comparison of efficacy and safety between rabbit anti-thymocyte globulin and anti-T lymphocyte globulin in kidney transplantation from donation after cardiac death: A retrospective cohort study
Comparison of efficacy and safety between rabbit anti-thymocyte globulin and anti-T lymphocyte globulin in kidney transplantation from donation after cardiac death: A retrospective cohort study
复制标题
DOI：
10.1111/nep.12469
复制
发表时间：
2015-08-01
期刊：
影响因子：
2.5
通讯作者：
Chen, Li-Zhong
中科院分区：
文献类型：
--
作者：
Chen, Guo-Dong;Lai, Xing-Qiang;Chen, Li-Zhong
目的 比较兔抗胸腺细胞球蛋白（Thymoglobulin）与抗T淋巴细胞球蛋白（ATG-Fresenius，ATG-F）在心脏死亡（DCD）捐献肾移植中的有效性和安全性。方法回顾性分析我院2007年2月至2013年10月实施的255例DCD肾移植病例。 根据胸腺球蛋白 (n=188) 或 ATG-F (n=67) 的诱导治疗，患者被分为两组。收集并比较两组的临床资料。结果胸腺球蛋白组有36例（19.1%）患者出现移植功能延迟（DGF），而ATG-F组有17例（25.4%）患者出现移植功能延迟（DGF）（P=0.281）。然而，如果我们对 DGF 危险因素增加的患者进行分组，胸腺球蛋白组的 DGF 率为 9/40 (22.5%)，而 ATG-F 组的 DGF 率为 9/16 (56.3%) (P=0.015)。胸腺球蛋白组的 DGF 持续时间明显较短（11.7 天 vs. 16.1 天）。胸腺球蛋白组的急性排斥反应率明显较低（9.6% vs. 19.4%，P=0.035）。胸腺球蛋白组和 ATG-F 组的一年移植物存活率和患者存活率相当。对于DGF危险因素增加的患者，ATG-F组和胸腺球蛋白组之间的DGF调整后的比值比为4.283（1.137-16.13）。结论与ATG-F相比，胸腺球蛋白可以减少DCD肾移植后DGF持续时间和急性排斥反应率。此外，胸腺球蛋白可显着降低 DGF 危险因素增加的患者的 DGF。 概览 本研究表明，在心脏死亡肾移植后捐献的 DGF 风险较高的患者中，胸腺球蛋白可能在降低延迟移植功能 (DGF) 方面具有优势。
AimTo compare the efficacy and safety between rabbit anti-thymocyte globulin (Thymoglobulin) and anti-T lymphocyte globulin (ATG-Fresenius, ATG-F) in donation after cardiac death (DCD) kidney transplantation.MethodsWe retrospectively analyzed 255 cases of DCD kidney transplantation performed at our hospital from February 2007 to October 2013. The patients were divided into two groups based on their induction therapies with Thymoglobulin (n=188) or ATG-F (n=67). Clinical data were collected and compared between the two groups.ResultsDelayed graft function (DGF) occurred in 36 (19.1%) patients in the Thymoglobulin group versus 17 (25.4%) patients in the ATG-F group (P=0.281). However, if we subgroup the patients with increased risk factors for DGF, the DGF rate was 9/40 (22.5%) in the Thymoglobulin group versus 9/16 (56.3%) in the ATG-F group (P=0.015). Duration of DGF was significantly shorter in the Thymoglobulin group (11.7 days vs. 16.1 days). The acute rejection rate was significantly lower in the Thymoglobulin group (9.6% vs. 19.4%, P=0.035). One-year graft and patient survival were both comparable between the Thymoglobulin and ATG-F groups. The adjusted odds ratio of DGF was 4.283 (1.137-16.13) between the ATG-F and Thymoglobulin groups in patients with increased risk factors for DGF.ConclusionCompared with ATG-F, Thymoglobulin may reduce duration of DGF and acute rejection rate after DCD kidney transplantation. Moreover, Thymoglobulin significantly reduced DGF in patients with increased risk factors for DGF.Summary at a Glance This study suggests that Thymoglobulin may have an advantage in reducing delayed graft function (DGF) in patients at higher risk for DGF in donation after cardiac death kidney transplantation.