Schweiger, Martin and Zuckermann, Andreas and Beiras-Fernandez, Andres and Berchtold-Herz, Michael and Boeken, Udo and Garbade, Jens and Hirt, Stephan and Richter, Manfred and Ruhpawar, Arjang and Schmitto, Jan Dieter and Schoenrath, Felix and Schramm, Rene and Schulz, Uwe and Wilhelm, Markus J. and Barten, Markus J. (2018) A Review of Induction with Rabbit Antithymocyte Globulin in Pediatric Heart Transplant Recipients. ANNALS OF TRANSPLANTATION, 23. pp. 322-333. ISSN 1425-9524
Full text not available from this repository. (Request a copy)Abstract
Pediatric heart transplantation (pHTx) represents only a small proportion of cardiac transplants. Due to these low numbers, clinical data relating to induction therapy in this special population are far less extensive than for adults. Induction is used more widely in pHTx than in adults, mainly because of early steroid withdrawal or complete steroid avoidance. Antithymocyte globulin (ATG) is the most frequent choice for induction in pHTx, and rabbit antithymocyte globulin (rATG, Thymoglobulin (R)) (Sanofi Genzyme) is the most widely-used ATG preparation. In the absence of large, prospective, blinded trials, we aimed to review the current literature and databases for evidence regarding the use, complications, and dosages of rATG. Analyses from registry databases suggest that, overall, ATG preparations are associated with improved graft survival compared to interleukin-2 receptor antagonists. Advantages for the use of rATG have been shown in low-risk patients given tacrolimus and mycophenolate mofetil in a steroid-free regimen, in sensitized patients with pre-formed alloantibodies and/or a positive donor-specific crossmatch, and in ABO-incompatible pHTx. Registry and clinical data have indicated no increased risk of infection or post-transplant lymphoproliferative disorder in children given rATG after pHTx. A total rATG dose in the range 3.5-7.5 mg/kg is advisable.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER; ANTI-THYMOCYTE GLOBULIN; HUMAN-LEUKOCYTE ANTIGEN; EPSTEIN-BARR VIRUS; INTERNATIONAL SOCIETY; CARDIAC TRANSPLANT; STEROID AVOIDANCE; THYMOGLOBULIN INDUCTION; RENAL-TRANSPLANTATION; RISK-FACTORS; Antilymphocyte Serum; Heart Transplantation; Pediatrics |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 30 Jun 2020 14:02 |
| Last Modified: | 30 Jun 2020 14:02 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14579 |
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