Comparing the noninfectious adverse effects of two rabbit anti-thymocyte globulin immunosuppression in kidney transplantation: a multicenter, retrospective study.

IF 3.6 3区医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Expert Opinion on Biological Therapy Pub Date : 2025-05-29 DOI:10.1080/14712598.2025.2512127

Mojtaba Shafiekhani, Ayda Esmaeili, Fatemeh-Sadat Emami, Kazem Heidari, Niloufar Saberi Moghadam, Shirinsadat Badri, Leila Kouti, Amir Hooshang Mohammadpour, Hadi Hamishehkar, Afshin Gharekhani, Maryam Amini-Pouya, Negin Zare, Fatemeh Abdoli, Mohammad Amin Jafarzadeh, Simin Dashti-Khavidaki

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引用次数: 0

Abstract

Background: Rabbit anti-thymocyte globulin (rATG) is widely used for induction immunosuppression in kidney transplantation; however, its administration carries some adverse effects. This study aimed to detect the incidence of thromboembolic events (TEEs) after kidney transplantation and the causality relationship between these events and rATG administration as induction therapy.

Methods: This multicenter retrospective study included 654 kidney recipients from six Iranian centers receiving [Thymoglobulin® (rATG-A) or TGlobulin25™ or (rATG-B)]. Outcomes included TEEs within 30 days post-transplant, hematologic adverse effects, and graft-related outcomes. Risk factors were analyzed using multivariable regression.

Results: TEEs occurred in 4.9% of patients, with no significant difference between rATG-A (4.0%) and rATG-B (5.9%) (p = 0.26). Independent risk factors included peripheral rATG infusion without heparin (p < 0.001), preexisting thromboembolic risk conditions (p < 0.001), cytomegalovirus (CMV) infection (p = 0.01), and recipient age >40 years (p = 0.02). No inter-band difference in thromboembolic risk was observed (odds ratio = 1.63, 95% confidence interval 0.71-3.76). Delayed graft function, rejection, mortality, and nephrectomy rates showed no inter-group differences.

Conclusion: TEEs happened in about 5% of the patients. Peripheral administration of rATG without adding heparin, history of underlying diseases predisposing to TEEs, CMV infection, and recipient age over 40 years were found as risk factors for the occurrence of TEEs.

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比较两种兔抗胸腺细胞球蛋白免疫抑制在肾移植中的非感染性不良反应：一项多中心、回顾性研究。

背景：兔抗胸腺细胞球蛋白（Rabbit anti-thymocyte globulin, rATG）广泛应用于肾移植诱导免疫抑制；然而，它的使用会带来一些副作用。本研究旨在检测肾移植术后血栓栓塞事件（tee）的发生率，以及这些事件与作为诱导治疗的给药鼠肝素之间的因果关系。方法：这项多中心回顾性研究包括来自伊朗6个中心的654名肾受体，他们接受了[胸腺球蛋白®（rat - a）或TGlobulin25™或（rat - b）]。结果包括移植后30天内的tee、血液学不良反应和移植物相关结果。采用多变量回归分析危险因素。结果：有4.9%的患者发生tee， rATG-A（4.0%）与rATG-B（5.9%）之间无显著差异（p = 0.26）。独立危险因素包括外周无肝素输注rATG （p p p = 0.01）和受体年龄（p = 0.02）。血栓栓塞风险无带间差异（优势比= 1.63,95%可信区间为0.71-3.76）。延迟移植功能、排斥反应、死亡率和肾切除术率没有组间差异。结论：tee发生率约为5%。外周给药不加肝素的rATG、易患tee的基础疾病史、CMV感染和受体年龄超过40岁是发生tee的危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Opinion on Biological Therapy 医学-生物工程与应用微生物

CiteScore

8.60

自引率

0.00%

发文量

审稿时长

3-8 weeks

期刊介绍： Expert Opinion on Biological Therapy (1471-2598; 1744-7682) is a MEDLINE-indexed, international journal publishing peer-reviewed research across all aspects of biological therapy. Each article is structured to incorporate the author’s own expert opinion on the impact of the topic on research and clinical practice and the scope for future development. The audience consists of scientists and managers in the healthcare and biopharmaceutical industries and others closely involved in the development and application of biological therapies for the treatment of human disease. The journal welcomes: Reviews covering therapeutic antibodies and vaccines, peptides and proteins, gene therapies and gene transfer technologies, cell-based therapies and regenerative medicine Drug evaluations reviewing the clinical data on a particular biological agent Original research papers reporting the results of clinical investigations on biological agents and biotherapeutic-based studies with a strong link to clinical practice Comprehensive coverage in each review is complemented by the unique Expert Collection format and includes the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results; Article Highlights – an executive summary of the author’s most critical points.