Abstract
Introduction: The goal of induction therapy in developing countries should be prevention of acute rejection with access to immunosuppressive therapy on a cost-effective basis for maintaining allograft function. Objectives: The objective of this study was to determine the incidence of acute rejection in the post-transplant period, on induction using single low dose thymoglobulin. Patients and Methods: We conducted a prospective study of 98 renal transplant recipients to see the effectiveness of single dose induction therapy with thymoglobulin. Results: The incidence of biopsy proven acute cellular rejection (ACR) was 8.16% in patients receiving thymoglobulin. The incidence of infection was 24.49%. We found a significant lymphocyte depletion in the immediate post-transplant period in thymoglobulin patients, with a mean of 500/µL in our cohort, for 4 to 10 post-operative days. Conclusion: This prospective study favours the administration of low single dose thymoglobulin as an effective induction agent with low rejection rates and cost effectiveness in resource poor settings.
Highlights
The goal of induction therapy in developing countries should be prevention of acute rejection with access to immunosuppressive therapy on a cost-effective basis for maintaining allograft function
Implication for health policy/practice/research/medical education: In a prospective study of 98 renal transplant recipients to see the effectiveness of single dose induction therapy with thymoglobulin, we found, administration of low single dose thymoglobulin is an effective induction agent as shown by low rejection rates and cost effectiveness, which can be useful in resource poor settings
Acute rejection episodes, which occur in the early engraftment period, could be either acute cellular rejection (ACR) or acute antibody-mediated rejection (AMR)
Summary
The goal of induction therapy in developing countries should be prevention of acute rejection with access to immunosuppressive therapy on a cost-effective basis for maintaining allograft function. Objectives: The objective of this study was to determine the incidence of acute rejection in the post-transplant period, on induction using single low dose thymoglobulin. Patients and Methods: We conducted a prospective study of 98 renal transplant recipients to see the effectiveness of single dose induction therapy with thymoglobulin. Viral and fungal infections in allograft recipients are the major causes of morbidity and mortality in India [1,2,3] In developing countries such as India, where medical insurance covers only 5% of the population, the goal should be the prevention of acute rejection with access to immunosuppressive therapy on a cost effective basis for maintaining allograft function. Since thymoglobulin and basiliximab are used at different dosages with multiple injections, induction therapy has
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