Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Induction therapy with rabbit anti-thymocyte globulin (ATG) in patients at low immunological risk remains controversial, given increased risk of cytomegalovirus (CMV) infection
*Methods: To investigate this, we studied 932 low-risk (defined as patients (PRA<50%) with living and standard donors) kidney transplant recipients (KTR) without CMV prophylaxis at Hospital do Rim, Brazil (1/3/13-9/16/15).
*Results: We used Cox and negative binomial regression to characterize post-transplant outcomes associated with 3mg/kg of ATG or no-induction after adjusting for baseline characteristics. Patients who received ATG 3mg/kg had 80% lower risk of acute rejection (aHR 0.140.190.25, p<0.001). While in the crude analysis, the risk of CMV infection was higher among patients receivingrATG versus no-induction (HR 1.051.331.68, p<0.001), after adjustments, the risk of CMV was similar among patients in each group (aHR 0.861.101.40, p=0.45). The association between ATG 3mg/kg and risk of infection varied by recipient pre-transplant CMV serostatus (p-interaction=0.006). Risk of graft loss (aHR 0.340.731.55, p=0.41), mortality (aHR 0.511.253.08, p=0.62) and post-KT hospital readmissions (aHR 0.750.931.14, p=0.47) were similar between those who received ATG versus no-induction.
*Conclusions: Among low-risk KTR receiving azathioprine, regardless of recipient pre-transplant CMV serostatus, single 3mg/kg dose of ATG was not associated with an increased risk of CMV infection. Therefore, pharmacological prophylaxis may not be necessary for low-risk CMV KTR.
To cite this abstract in AMA style:Paula MIvanide, Bowring MGrace, Shaffer AA, Garonzik-Wang J, Bessa ABarros, Felipe CRosso, Cristelli MPontello, Massie AB, Pestana JMedina, Junior HSilva, Segev DL. No Indication of Increased CMV Infection in Kidney Transplant Recipients without Pharmacological Prophylaxis Receiving a Single 3mg/kg Dose of Rabbit Anti-Thymocyte Globulin (ATG) Instead of No-Induction [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/no-indication-of-increased-cmv-infection-in-kidney-transplant-recipients-without-pharmacological-prophylaxis-receiving-a-single-3mg-kg-dose-of-rabbit-anti-thymocyte-globulin-atg-instead-of-no-induct/. Accessed May 5, 2021.
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