Antithymocyte Globulin Induction Therapy Adjusted for Immunologic Risk After Heart Transplantation

Impact of induction immunosuppression on survival in heart transplant recipients: a contemporary analysis of agents

“…Moreover, these investigators found no difference in acute rejection episodes . However, this increased risk of infection with thymoglobulin has not been universally reported . The use of either thymoglobulin or IL‐2Rab appears to have a similar impact on first year survival and rejection episodes .…”

“…In our analysis of the UNOS/STAR database, we found that the use of antibody based induction immunosuppression in heart transplant recipients, in general, is not associated with significant differences in overall survival. Previously published reports have demonstrated an accepted improvement in general outcomes with antibody based induction therapy .…”

“…This would be an important question to answer in the setting of induction therapy. A potential downside is that there could be a predisposition to increased infection with induction therapy, in particular with cytomegalovirus but reports are inconsistent in this matter . Similarly, information on whether patients developed malignancies or cardiac allograft vasculopathy during follow‐up was not available, as well as certain demographic factors, such as pre‐transplant PRA,…”

Induction regimen and survival in simultaneous heart-kidney transplant recipients

“…[36][37][38] In another study, which used prospectively dose-adjusted ATG induction therapy based on immunologic risk, there were excellent and equivalent short and long-term survival rates, with a low incidence of cellular and antibodymediated rejection. 39 Other potential benefits of r-ATG in HT may include lower risk of ischemia-reperfusion injury, 40 reduced coronary plaque progression (as assessed by intravenous ultrasound) within the first year after transplant, 41 and prolonged effect on LD, lasting 6 months or longer. 42 In renal transplantation, a larger randomized trial with 278 high-risk patients found that r-ATG (cumulative dose, 7.5 mg/kg) achieved a significantly lower rate of acute rejection (15.6% vs 25.5%) and antibody-treated rejection (1.4% vs 8.0%) compared with IL-2RA induction, although graft survival, delayed graft function, and patient survival were unaffected.…”

Combined Heart-Kidney Transplantation After Total Artificial Heart Insertion

“…Endomyocardial biopsy on days 15 and 30 post-transplantation showed no evidence of cellular rejection or antibody-mediated rejection (AMR). On day 45 post-transplant, the biopsy showed mild acute cellular rejection (grade 1A-1R) and no evidence of AMR [10]. A Doppler echocardiogram showed normal left and right ventricular function.…”