Study of the correlation between two methods used to monitor thymoglobulin therapy in renal transplantation

Franco, Antônio; Alvarez, Luis F Chacín; Gimeno, Adelina; Sen, Manoj; Muñoz, Carlos; Sánchez‐Paya, José; Jiménez, L.; Olivares, José

doi:10.1016/s0041-1345(03)00577-3

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…However, Franco et al. reported that total lymphocyte counts do not correlate with CD3 counts (a marker of T‐lymphocyte population) in kidney transplant patients treated with rATG. As the CD3 count more accurately reflects the T‐lymphocyte population, this has led to the use of flow cytometry and absolute CD3 count by some transplant programs, including ours, to monitor rATG induction.…”

Section: Discussionmentioning

confidence: 99%

Role for immune monitoring to tailor induction prophylaxis in pediatric heart recipients

Thrush

Gossett

Costello

et al. 2013

Pediatric Transplantation

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Tailoring rATG induction with CD3 monitoring results in less infection, reduced costs, and similar rejection. Retrospective review of HTx recipients receiving rATG induction. Control cases received "usual" rATG dosing (1.5 mg/kg/day typically × 5 days). Starting in October 2009, absolute CD3 monitoring (target <25 cells/mm(3) ) guided rATG dosing (study cases). Outcomes included first-year incidence of infection/rejection, direct costs of therapy, and incidence of PTLD/death. Study cases (n = 32) received fewer doses of rATG (median 4 vs. 5, p < 0.001) and less total rATG (median 3.2 vs. 7.4 mg/kg, p < 0.001) compared with controls (n = 17). There was no difference in incidence of infection, rejection, or patient survival during the first year post-HTx. There was one early death in both groups and one late case of PTLD in the control group. Drug savings were significant (median drug cost per patient $2718 vs. $4756, p < 0.001). CD3-tailored rATG induction in HTx recipients is associated with reduced drug costs and similar rates of rejection/infection. Longer follow-up will determine whether extended benefits are associated with this induction monitoring strategy.

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Section: Discussionmentioning

confidence: 99%

Role for immune monitoring to tailor induction prophylaxis in pediatric heart recipients

Thrush

Gossett

Costello

et al. 2013

Pediatric Transplantation

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“…( 28 ) In that same study, peripheral blood lymphocyte counts <200 cells/mm3 and CD3 + T cell counts <20 cells/mm3 were found to be highly correlated in a small sample of patients. Franco et al, ( 29 ) evaluated 298 samples obtained from 24 kidney transplant recipients receiving ATG for induction or treatment of acute rejection. Cut-off values of 10 CD3 + T cells/mm 3 and <100 peripheral blood lymphocytes/ mm 3 were used in that study, with significant correlations limited to days 5 and 15 of ATG administration.…”

Section: Discussionmentioning

confidence: 99%

“…Significant differences between methods were therefore reported. ( 29 ) Ata et al, analyzed two groups of renal transplant patients undergoing ATG-based induction therapy and monitored via total lymphocyte or CD3 + T cell counts. Higher immunomodulation instability requiring higher doses of ATG and implying higher costs was observed in the first group.…”

Section: Discussionmentioning

confidence: 99%

Polyclonal anti T-lymphocyte antibody therapy monitoring in kidney transplant recipients: comparison of CD3+ T cell and total lymphocyte counts

Machado

Vicari

Spuldaro

et al. 2018

Einstein (São Paulo)

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Objective:To investigate the correlation between total lymphocyte and CD3+ T cell counts in peripheral blood in renal transplant patients treated with anti-thymocyte globulin, and discuss related outcomes.Methods:A single-center, retrospective study involving 226 patients submitted to kidney transplant between 2008 and 2013, and treated with anti-thymocyte globulin for induction or treatment of cellular rejection. Doses were adjusted according to CD3+ T cell or total lymphocyte counts in peripheral blood.Results:A total of 664 paired samples were analyzed. The Spearman's correlation coefficient was 0.416 (p<0.001) for all samples combined; the overall Kappa coefficient was 0.267 (p<0.001). Diagnostic parameters estimated based on total lymphocyte counts were also calculated using the number of CD3+ T cells (gold standard), with a cut off of >20 cells/mm3.Conclusion:Total lymphocyte and CD3+ T cell counts in peripheral blood are not equivalent monitoring strategies in anti-thymocyte globulin therapy.

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“…14 Indeed, numerous studies have shown similar clinical outcomes with rATG induction therapy despite widely varying dosing schemes; these include every-otherday dosing, withholding doses on the basis of absolute CD3 counts, and administering the total rATG as a 1time infusion, among others. 13,[15][16][17][18][19][20][21][22][23][24][25][26][27][28] Outpatient peripheral administration of rATG is an absolute necessity to facilitate a process such as the one presented here. Going strictly by the package insert, the use of rATG in this capacity would be considered inappropriate.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Economic Analysis of Delayed Administration of Antithymocyte Globulin for Induction Therapy in Kidney Transplantation

et al. 2013

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Patients who had delayed administration of rabbit antithymocyte globulin had shorter stays (3.9 vs 3.1 days, P< .001) and reduced inpatient costs for rabbit antithymocyte globulin (mean $860/patient); these changes were achieved without affecting acute rejection rates (5% vs 5%, P> .99) or readmission rates. In conclusion, delayed inpatient administration of rabbit antithymocyte globulin provided identical clinical outcomes while helping to reduce inpatient costs and increase timely discharges.

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Study of the correlation between two methods used to monitor thymoglobulin therapy in renal transplantation

Cited by 4 publications

References 4 publications

Role for immune monitoring to tailor induction prophylaxis in pediatric heart recipients

Role for immune monitoring to tailor induction prophylaxis in pediatric heart recipients

Polyclonal anti T-lymphocyte antibody therapy monitoring in kidney transplant recipients: comparison of CD3+ T cell and total lymphocyte counts

Clinical and Economic Analysis of Delayed Administration of Antithymocyte Globulin for Induction Therapy in Kidney Transplantation

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