A: Our study is a retrospective analysis of heart transplant recipients transplanted in 2009 and were induced with rATG vs. no induction. We hypothesized that induction therapy for heart transplantation with rATG improves patients and grafts survival.
B: 59 patients received heart transplant in 2009 at Tampa General Hospital. Induction therapy with rATG was used in the group of patients who developed hemodynamics instability, acute kidney injury and/or expected positive cross match in highly sensitized recipients. 34 patients were not induced vs. 22 patients received rATG. We considered induction if patient receive at least 3 mg/kg of rATG starting no longer than 24 hours post transplantation. Contingency with Fischer test was used for the incidence of rejection. Unpaired t test with Welch's correction for biopsy scoring, tacrolimus level, PRA analysis and donor specific antibodies
C: Following recipients for three years showed significant survival benefit with using rATG as induction agent vs. no induction (p<0.03).
The group received 3 mg/kg of rATG compared to no induction developed significant less incidence of rejection and better pathological score with protocoled and indicated myocardium biopsies (p<0.015). We analyzed the Tacrolimus trough level at the time of first rejection and the two groups showed no difference (p<0.96). We found no effect of rATG on DSA developments and the two groups were similar in the severity of pre transplant sensitization.
D: The current statement of ISHLT guidelines for immunosuppression management for heart transplant recipients is While having comparable effects on rejection, monoclonal and polyclonal antibodies are associated with different adverse effects and types of infection. Generally data on outcomes beyond 6 months to 1year are lacking.
Our study provides strong evidence of three years rejection and survival benefit in heart transplant recipients induced with rATG. We also provide evidences of no effect and/or role of rATG on PRA or DSA.
To cite this abstract in AMA style:Jarmi T, Naif A, Weston M. Thymoglobulin (rATG) Induction Improves Survival in Heart Transplant Recipients: A Retrospective Single-Center Study [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/thymoglobulin-ratg-induction-improves-survival-in-heart-transplant-recipients-a-retrospective-single-center-study/. Accessed September 23, 2017.
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