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Ideal Body Weight versus Actual Body Weight for Rabbit Antithymocyte Globulin Induction in Pancreas Transplantation

E. Martinez,1 D. Felix,2 J. Wiegel,2 T. Al-Qaoud,1 G. Leverson,1 A. Condon,2 R. Redfield,1 J. Odorico.1

1Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
2Department of Pharmacy, UW Health, Madison, WI.

Meeting: 2018 American Transplant Congress

Abstract number: A350

Keywords: Immunosuppression, Induction therapy, Pancreas transplantation, Weight

Session Information

Session Name: Poster Session A: Pancreas and Islet: All Topics

Session Type: Poster Session

Date: Saturday, June 2, 2018

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Purpose: Rabbit antithymocyte globulin (rATG) is the most commonly used induction agent in solid organ pancreas transplantation. The optimal induction dosing of rATG, has not been determined. Historically, actual body weight (ABW) dosing of rATG has been administered. We sought to evaluate the 1 year pancreas allograft rejection rate using ideal body weight (IBW) versus ABW induction rATG dosing.

Methods: All pancreas transplant recipients receiving rATG induction between 1/2013 and 7/2016 were reviewed. A retrospective cohort analysis on intention to treat dosing strategy was performed between IBW and ABW dosing or rATG. Service protocol changed rATG induction dosing from 6 mg/kg of ABW to IBW within the study period. Minimum 1 year follow up was sought. Patients with early technical graft loss or death due to trauma were excluded. Baseline demographic data, rejection, infection, readmission rates, and rATG dosing data were analyzed.

Results: Sixty patients met study criteria, 32 ABW and 28 IBW patients. Baseline demographic data, maintenance immunosuppression regimens, readmission rates, and patient survival were not significantly different between the IBW and ABW groups, with the latter two being equal. Infection rates (68% vs 78%, p=0.37) and pancreas allograft rejection at 1 year (22% vs 28%, p=0.41) were not significantly different between the IBW and ABW groups. Pancreas graft survival was significantly different between IBW and ABW (100% vs 81%, p=0.036). The average ABW rATG dose received before and after conversion to IBW dosing were 5.74 mg/kg vs 5.19 mg/kg, respectively.

Conclusion: Our results indicated that the use of ideal body weight dosing for rATG induction therapy in pancreas transplantation does not incur a significantly different rate of pancreas allograft rejection. Furthermore, given similar infection and patient survival, patient safety does not seem to be compromised.

CITATION INFORMATION: Martinez E., Felix D., Wiegel J., Al-Qaoud T., Leverson G., Condon A., Redfield R., Odorico J. Ideal Body Weight versus Actual Body Weight for Rabbit Antithymocyte Globulin Induction in Pancreas Transplantation Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Martinez E, Felix D, Wiegel J, Al-Qaoud T, Leverson G, Condon A, Redfield R, Odorico J. Ideal Body Weight versus Actual Body Weight for Rabbit Antithymocyte Globulin Induction in Pancreas Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/ideal-body-weight-versus-actual-body-weight-for-rabbit-antithymocyte-globulin-induction-in-pancreas-transplantation/. Accessed June 6, 2025.

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