Anti-Thymocyte Globulin Induction Does Not Increase the Risk of Thrombotic Events in Kidney Transplantation: A Matched Case-Control Study.
1Department of Pharmacy, University of Rochester, Rochester, NY
2Department of Surgery, Division of Transplantation and Hepatobiliary Surgery, University of Rochester, Rochester, NY
3Department of Medicine, Division of Nephrology, University of Rochester, Rochester, NY
4School of Medicine and Dentistry, University of Rochester, Rochester, NY.
Meeting: 2016 American Transplant Congress
Abstract number: C54
Keywords: Antilymphocyte antibodies, Kidney transplantation, Post-operative complications, Risk factors
Session Information
Session Name: Poster Session C: Clinical Science - Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Anti-thymocyte globulin (ATG) is the most commonly used induction agent in kidney transplantation (KTx). To date, case reports and in vitro analyses have suggested an association between ATG induction and coagulopathy. The purpose of this study was to examine the association between ATG induction and thrombotic events (TEs) in kidney recipients.
Methods: We conducted a retrospective case-control study from a cohort of consecutive adult KTx recipients transplanted between January 1, 2011 and April 30, 2015. We compared patients with and without TEs to identify risk factors for thrombosis. We identified 19 subjects that developed TE after transplantation (defined as any clinically significant arterial or venous clot). Forty-seven matched controls were selected from the remaining cohort and matched on age, sex, pre-transplant history of TE, and history of smoking. Data extraction sources included the in-patient admission and discharge summaries, laboratory reports, and clinic follow-up dictation notes.
Results: The postoperative incidence of TE was 7.4% (n = 19) in the first 6 months after KTx. Among the 19 patients, four experienced arterial events (including one myocardial infarction and one stroke) and 16 experienced venous events (including 14 deep vein thromboses and one pulmonary embolism) a median of 40 days (range: 1-183) after KTx. A thrombotic event occurred in 5/16 (31.3%) patients treated with ATG versus 14/50 (28.0%) patients that received other induction therapies (OR 1.12, CI 0.4-4.0). Patients that received post-transplant aspirin and those on dialysis for a longer duration were less likely to clot. Type of transplant (living vs. deceased), diagnosis of diabetes mellitus, and length of hospitalization were not associated with TE in our matched cohort.
Conclusions: Our results do not confirm previous observations that ATG increases the risk of thrombotic events after KTx. Larger cohort studies are needed to validate the results of this study.
CITATION INFORMATION: Iuppa J, Dokus M, Venniro E, Patel A, Danzig A, Hahn J, Kashyap R, Orloff M, Taylor J. Anti-Thymocyte Globulin Induction Does Not Increase the Risk of Thrombotic Events in Kidney Transplantation: A Matched Case-Control Study. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Iuppa J, Dokus M, Venniro E, Patel A, Danzig A, Hahn J, Kashyap R, Orloff M, Taylor J. Anti-Thymocyte Globulin Induction Does Not Increase the Risk of Thrombotic Events in Kidney Transplantation: A Matched Case-Control Study. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/anti-thymocyte-globulin-induction-does-not-increase-the-risk-of-thrombotic-events-in-kidney-transplantation-a-matched-case-control-study/. Accessed May 10, 2025.« Back to 2016 American Transplant Congress