In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 3 ( 2023-3-1), p. e0280924-
Abstract:
The optimal dose of anti-thymocyte globulin (ATG) as an induction regimen in Asian living-donor kidney recipients is unclear. Methods This is a pilot study in which 36 consecutive patients undergoing living-donor kidney transplantation were randomly assigned to receive either 4.5 mg/kg (n = 19) or 6.0 mg/kg (n = 17) of ATG; all patients had corticosteroid withdrawal within 7 days. The primary end point was a composite of biopsy-proven acute rejection, de novo donor-specific antibody formation, and graft failure. Results At 12 months post-transplant, biopsy-proven acute rejection was more common in the ATG4.5 group (21.1%) than in the ATG6.0 group (0%)( P = .048). Importantly, the rate of the composite end point was significantly higher in the ATG4.5 group (36.8% vs 0%)( P = .006). There were significant differences in neither the renal function nor adverse events between the two groups. One case of death-censored graft failure occurred in the ATG4.5 group and no mortality was observed overall. Compared with pre-transplantation, T cells, natural killer (NK) cells, and natural killer T (NKT) cells were significantly decreased in the first week post-transplantation except for B cells. Although T and NKT cells in both groups and NK cells in the ATG4.5 group had recovered to the pre-transplant levels, NK cells in the ATG6.0 group remained suppressed until six months post-transplant. Conclusions Compared with ATG 6.0 mg/kg, ATG 4.5 mg/kg with early corticosteroid withdrawal and low dose maintenance regimen was associated with higher rates of acute rejection in non-sensitized Asian living-donor kidney recipients. Trial registration ClinicalTrials.gov: NCT02447822 .
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0280924
DOI:
10.1371/journal.pone.0280924.g001
DOI:
10.1371/journal.pone.0280924.g002
DOI:
10.1371/journal.pone.0280924.g003
DOI:
10.1371/journal.pone.0280924.g004
DOI:
10.1371/journal.pone.0280924.g005
DOI:
10.1371/journal.pone.0280924.g006
DOI:
10.1371/journal.pone.0280924.t001
DOI:
10.1371/journal.pone.0280924.t002
DOI:
10.1371/journal.pone.0280924.t003
DOI:
10.1371/journal.pone.0280924.s001
DOI:
10.1371/journal.pone.0280924.s002
DOI:
10.1371/journal.pone.0280924.s003
DOI:
10.1371/journal.pone.0280924.s004
DOI:
10.1371/journal.pone.0280924.s005
DOI:
10.1371/journal.pone.0280924.s006
DOI:
10.1371/journal.pone.0280924.s007
DOI:
10.1371/journal.pone.0280924.s008
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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