Thymoglobulin Induction Therapy and Renal Graft Survival in Patients at the Hospital de Especialidades, Centro Medico Nacional de Occidente, Jalisco, Mexico.

Abstract

Introduction. Induction with Thymoglobulin offers advantages such as reducing the frequency of acute rejection and improved graft function. Objective. To evaluate renal graft function and graft survival in patients receiving Thymoglobulin induction. Materials and Methods: A retrospective cohort, in the period June 2010 to December 2013 included renal transplants patients who has over 15 years of age, any kind donor and who received induction therapy with Thymoglobulin. Excluded patients with graft loss in the 1st week of renal transplantation, or its follow up was lost. Was recorded the dose cumulative mean of Thymoglobulin, and serum creatinine at 12 months, 2 years and 3 years of renal transplantation (Table 1), to assess graft function. Kaplan-Meier estimates of freedom from death and graft loss. The frequency of acute rejection-free period it was obtained, and secondarily, freedom from infection- related death and posttrasplant frequency of infections and lymphoproliferative disorders (Table 2). Results: 250 patients were included, which received initial doses of Thymoglobulin 0.7mg/kg- 1.5mg/kg. A 70 percent received living donor transplants and 30 percent of deceased donor.Table: No Caption available.Table: No Caption available.Actual patient and graft survival were 98% (n=250) at 12 months. Kaplan-Meier estimates of freedom from death and graft loss, through 2 years were 98.3% and 97.8% (n=185), respectively, and 96% (4/98) and 93.9% (n=98), through 3 years. Discussion. Induction with Thymoglobulin allowed good graft function and survival. The mean cumulative dose of Thymoglobulin induction was consistent with recent literature reporting similar outcomes and safety profile, during the course of the registry, we observed a decline in mean dose. We can conclude that the use of Thymoglobulin as induction agent in our patients at high immunological risk, is safe and associate with excellent patient survival and low rates of acute rejection renal graft survival.