ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Thymoglobulin Induction Protocol: Quality Improvement Project via Clinical Audit

S. Mouawad1, J. Dann1, A. Kumar2, S. Rao3

1University of Virginia Health System, Charlottesville, VA, 2Nephrology, University of Virginia, Charlottesville, VA, 3University of Virginia, Charlottesville, VA

Meeting: 2022 American Transplant Congress

Abstract number: 608

Keywords: Antilymphocyte antibodies, Dosage, Immunosuppression, Induction therapy

Topic: Administrative » Administrative » 01 - Quality Assurance Process Improvement & Regulatory Issues

Session Information

Session Name: Quality Assurance Process Improvement & Regulatory Issues

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

 Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: The aim of our study was to analyze the adequacy of the thymoglobulin (rATG) induction protocol for the expanding and higher complexity kidney transplant (KT) population being performed at our center and propose evidence based updates.

*Methods: A single center, prospective data collection for KT performed between February and July 2021 was conducted. Treating physicians were advised on recommended rATG dose based on the risk-stratification as per the induction protocol (Fig 1), with final dose determined by physician. Reasons for dose modification were captured and analyzed, followed by recommendations on updating protocol based on literature review.

*Results: 59 KT, with mean age of 52 years, 54% Caucasian and 33% African Americans (AA) ,15% prior transplants, 68% deceased donor, were studied. According to the risk stratification: 44% were low risk, 37% were high risk, 19% were elderly.The protocol deviation was high (39%), with the majority receiving higher rATG dose (n=19) due to pre-existing donor specific antibodies (DSA) and panel reactive antibody (PRA) (n=6), high BMI (n=6), inadequate lymphocyte depletion, steroid-withdrawal regimen, and perceived low total rATG dose (adjusted body weight (BW) used rather than actual BW). However, these dose modifications were not uniformly applied, with no statistical difference in rATG doses based on BMI, age, DSA, or PRA. The results were presented to transplant team members along with the literature review on key topics (BMI, AA, PRA/DSA, lymphocyte depletion, appropriate weight for rATG dose, steroid-free regimens) and suggestions of protocol modification. After deliberations, the protocol has been updated with goal to decrease deviations by 50%, monitored by prospective clinical audit (Table 1).

*Conclusions: Utilizing clinical audit to quantify and qualify the performance shortfalls of rATG induction protocol, we successfully implemented system based protocol modifications to reflect the changing needs of the KT program and prevailing standard of care. We propose that clinical audit of protocols in the KT is a valuable tool for quality improvement and enhances patient care.

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Mouawad S, Dann J, Kumar A, Rao S. Thymoglobulin Induction Protocol: Quality Improvement Project via Clinical Audit [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/thymoglobulin-induction-protocol-quality-improvement-project-via-clinical-audit/. Accessed May 9, 2025.

« Back to 2022 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences