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- Title
Thymoglobulin induction and steroid avoidance in cardiac transplantation: results of a prospective, randomized, controlled study.
- Authors
Yamani, Mohamad H.; Taylor, David O.; Czerr, Jennifer; Haire, Christinna; Kring, Richard; Lingmei Zhou; Hobbs, Robert; Smedira, Nicholas; Starling, Randall C.
- Abstract
Background: Chronic use of corticosteroids (CS) following transplantation is associated with significant long-term morbidities. Minimizing exposure to CS to improve long-term outcomes, without compromising allograft function, remains an important goal in transplantation. Objectives: This single-center, prospective, randomized, open-label study was designed to evaluate the efficacy of Thymoglobulin® as part of a CS-sparing regimen in cardiac transplantation. Methods: Thirty-two low-risk cardiac transplant patients were randomized in a 1:1 ratio to receive either a Thymoglobulin-based CS-avoidance regimen (CS-avoidance group; n = 16) or a long-term CS-based regimen with no antibody induction (control group; n = 16). Pulse CS therapy was used for the treatment of acute cellular rejection in both groups. Results: Baseline characteristics were similar between groups. At one yr, there was no significant difference in the mean incidence of acute cellular rejection (≥3A) episodes between the CS-avoidance and control groups, 0.81 ± 1.05 and 1.07 ± 1.03, respectively. Importantly, the CS-avoidance patients had significant improvement in muscle strength and less bone loss compared with the control patients during the first six months post-transplant. Conclusions: CS-avoidance regimen with Thymoglobulin induction appeared to be safe and effective in cardiac transplantation. Further studies are required to demonstrate the long-term safety and benefits of such a regimen.
- Subjects
GLOBULINS; ADRENOCORTICAL hormones; STEROIDS; HEART transplantation; TRANSPLANTATION of organs, tissues, etc.
- Publication
Clinical Transplantation, 2008, Vol 22, Issue 1, p76
- ISSN
0902-0063
- Publication type
Article
- DOI
10.1111/j.1399-0012.2007.00748.x