Nineteen years of experience utilizing anti-T-Lymphocyte globulin induction in pediatric kidney transplantation

作者：Mota Conceicao^*; Martins Lassalete; Costa Teresa; Dias Leonidio; Almeida Manuala; Santos Josefina; Faria M Sameiro; Henriques A Castro; Almeida Rui

来源：Annals of Transplantation, 2010, 15(4): 84-91.

• pediatric renal transplantation
• deceased donor
• immunosuppression

Backgroud: The optimal immunosuppressive therapy in kidney transplantation remains controversial. Since 1990, we included, in our department, anti-T-Lymphocyte globulin Fresenius (R) (ATGF) in a sequential immunossupressive therapy in pediatric recipients of deceased donor kidneys. We analysed retrospectively the complications and long-term outcomes.
Material/Methods: Ninety eight kidney transplants were performed in 91 children and adolescents between November 1990 and October 2009, using deceased donor source grafts. In 86.8% of the recipients ATG-F was used as antibody induction and in 12.2% of the recipients no ATG-F induction was used.
Results: Overall graft survival rates at 1, 5, 10 and 15 years were 91.8%, 86.1%, 75.9% and 61.9% respectively. In the ATG-F group the graft survival at 1, 5, 10 and 15 years was 93%, 89.1%, 79%, 62.4% and in group without ATG-F it was 83.3%, 66.7%, 55.6% at 1, 5, 10 years respectively (p=0.27). The overall incidence of infection was 1.6/patient in the first year post-transplantation and almost all were of mild or moderate intensity. A papillary thyroid carcinoma was diagnosed in one patient and no lymphoid malignancies were observed during the observational period. All patients were alive at the end of follow-up, except one who died of cardiovascular disease, 7 months after graft loss.
Conclusions: These results indicate that ATG-F induction in pediatric kidney transplantation using deceased donor kidneys is associated with good graft and patient survival rates, and with low levels of complications.

• 出版日期2010-12