15 May 2018 : Review article
A Review of Induction with Rabbit Antithymocyte Globulin in Pediatric Heart Transplant Recipients
Martin Schweiger1EF*, Andreas Zuckermann2EF, Andres Beiras-Fernandez3EF, Michael Berchtolld-Herz4EF, Udo Boeken5EF, Jens Garbade6EF, Stephan Hirt7EF, Manfred Richter8EF, Arjang Ruhpawar9EF, Jan Dieter Schmitto10EF, Felix Schönrath11EF, Rene Schramm12EF, Uwe Schulz13EF, Markus J. Wilhelm14EF, Markus J. Barten15EFDOI: 10.12659/AOT.908243
Ann Transplant 2018; 23:322-333
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®) (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.
Keywords: Antilymphocyte Serum, Heart Transplantation, Pediatrics
In Press
Case report
Pulmonary Embolism Following Living Donor Hepatectomy: A Report of 4 Cases and Literature ReviewAnn Transplant In Press; DOI: 10.12659/AOT.946752
Most Viewed Current Articles
03 Jan 2023 : Original article 6,527
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...DOI :10.12659/AOT.938467
Ann Transplant 2023; 28:e938467
15 Aug 2023 : Review article 6,222
Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ TransplantationDOI :10.12659/AOT.939750
Ann Transplant 2023; 28:e939750
16 May 2023 : Original article 6,152
Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...DOI :10.12659/AOT.939258
Ann Transplant 2023; 28:e939258
17 Jan 2023 : Original article 5,279
Non-Cryopreserved Peripheral Blood Stem Cell Graft for Autologous Hematopoietic Stem Cell Transplantation i...DOI :10.12659/AOT.938595
Ann Transplant 2023; 28:e938595