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- Title
Thymoglobulin for induction or rejection therapy in pancreas allograft recipients: a single centre experience.
- Authors
Trofe, Jennifer; Stratta, Robert J; Egidi, M Francesca; Lo, Agnes; Gaber, Lillian W; Shokouh-Amiri, M Hosein; Grewal, Hani P; Honaker, Marsha; Hardinger, Karen; Alloway, Rita R; Gaber, A Osama
- Abstract
Purpose: To review the safety and efficacy of thymoglobulin in pancreas transplant patients receiving tacrolimus and mycophenolate mofetil. Methods: Retrospective, single centre analysis of 45 patients transplanted between 1995 and 2000 who received 54 courses of thymoglobulin, including 36 courses in 29 solitary pancreas transplant recipients (16 pancreas alone, 13 pancreas after kidney transplants) and 18 courses in 16 simultaneous kidney–pancreas transplant patients. Thirty-two patients (71%) were primary pancreas transplants, 10 (22%) were second transplants and three (7%) were third transplants. Of the 54 treatment courses, 19 (35%) were for induction, 27 (50%) were for primary rejection and eight (15%) were rescue therapy for rejection. All rejection episodes were biopsy-proven in at least one organ Results: The median thymoglobulin dose was 1.5 mg/kg/d with a mean of six doses (range 3–10). Dose reduction or interruption was required in 28 courses (52%), most often due to leukopenia (n = 24), fever (n = 2) and thrombocytopenia (n = 2). Thymoglobulin was resumed in all but three patients, two with persistent fever and one with infection. Infectious complications (n = 25) occurred in 17 patients (38%) within 30 days and included bacterial (n = 16), cytomegalovirus (n = 4), polyoma (n = 1), fungal (Candida albicans , n = 1), toxoplasmosis (n = 1) and ehrlichiosis (n = 2). Post-transplant lymphoproliferative disease occurred in two patients (4%) at a mean of 70 d post-thymoglobulin treatment. In the 19 patients that received thymoglobulin induction, one simultaneous kidney–pancreas transplant, two pancreas alone and four pancreas after kidney transplant recipients developed rejection (37% incidence), while all remaining patients followed by surveillance protocol biopsies were rejection-free. In the 35 patients that received thymoglobulin for rejection, reversal occurred in 26 of the patients (74%). Rejection recurred within 30 d in five...
- Subjects
PANCREAS transplantation; TACROLIMUS
- Publication
Clinical Transplantation, 2002, Vol 16, p34
- ISSN
0902-0063
- Publication type
Article
- DOI
10.1034/j.1399-0012.16.s7.5.x