Low Total Dose of Anti-Human T-Lymphocyte Globulin (ATG) Guarantees a Good Glomerular Filtration Rate after Liver Transplant in Recipients with Pretransplant Renal Dysfunction
Dopazo, Cristina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Charco, Ramon (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Caralt, Mireia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Pando, Elizabeth (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Lázaro, José Luis (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Gómez Gavara, Concepción (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Castells, Lluís (Hospital Universitari Vall d'Hebron)
Bilbao, Itxarone (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Data:	2018
Resum:	We aimed to evaluate the safety and efficacy of low doses of anti-T-lymphocyte globulin (ATG)-based immunosuppression in preserving renal function and preventing liver rejection in liver transplant (LT) recipients with pretransplant renal dysfunction. We designed a prospective single-center cohort study analyzing patients with pre-LT renal dysfunction defined as eGFR<60 mL/min/1. 73m 2, who underwent induction therapy with ATG (ATG group, n=20). This group was compared with a similar retrospective cohort treated with basiliximab (BAS group, n=20). An economic analysis between both induction therapies was also undertaken. In the ATG group, 45% and 50% of patients had recovered their renal function without acute cellular rejection (ACR) episodes at day 7 and 1 month after LT, respectively, versus 40% and 55% of patients in the BAS group (p=1). Renal function improved in both groups over time and no differences between groups were observed regarding one-year eGRF and one-year probability of ACR. Cost per patient of the ATG course was 403€ (r: 126-756) versus 2,524€ of the basiliximab course (p=0. 001). In conclusion, induction with low dose of ATG or basiliximab in patients with pretransplant renal dysfunction is a good strategy for preserving posttransplant renal function; however the use of low-dose ATG resulted in a substantial reduction in drug costs.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Canadian Journal of Gastroenterology & Hepatology, Vol. 2018 (august 2018) , ISSN 2291-2797

DOI: 10.1155/2018/1672621
PMID: 30186817

7 p, 849.5 KB

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