Is ATG Induction with Delayed Initiation of CNI Protective of Renal Function in Patients with Mild Renal Insufficiency?

PurposeRabbit anti-thymocyte globulin (ATG) therapy has been used for induction to allow delay of initiation calcineurin inhibitor (CNI) immediately post-heart transplant (HTx) in patients with moderate severe renal insufficiency. In our program, this approach routine serum creatinine >2.0 mg/dL. Although mode shown be effective protection, its benefit not established less insufficiency, the 1.5-2.0 mg/dL range. Therefore, we reviewed patient population assess whether ATG was renal-protective these patients.MethodsBetween 2010 and 2020, assessed 84 baseline range who underwent HTx, divided them into those from CNI did not. Patients given (x 5 days) had delayed beginning on days 3-5 post-operatively once urine output established. Endpoints included comparison glomerular filtration rate (GFR) at baseline, change 6- 12-months each group. addition, 1-year freedom temporary chronic dialysis (occurring greater than 30 postop) rejection (any treated [ATR], acute cellular [ACR], antibody mediated [AMR]) assessed.ResultsThere no significant difference compared control function (creatinine/GFR) GFR 6 months 1 year post-HTx. there between groups or dialysis, ATR, ACR, AMR.ConclusionATG does appear beneficial kidney mild Larger studies are needed confirm findings. Rabbit patients. Between assessed. There AMR.