COMPARISON OF ANTI-HUMAN T-LYMPHOCYTE IMMUNOGLOBULIN (R-ATLG) VS. ANTI-THYMOCYTE GLOBULIN (R-ATG) AS AN INDUCTION AGENT IN KIDNEY TRANSPLANTATION: A 5-YEAR RETROSPECTIVE SINGLE CENTER OBSERVATIONAL STUDY

8 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-2364, Poster Board= SAT-398

Introduction:

T cell depletion agents, Anti-Thymocyte Globulin (r-ATG) and Anti-Human T-Lymphocyte Immunoglobulin (r-ATLG), are routinely employed as induction therapies in kidney transplantation. This study systematically evaluates the short-term and long-term outcomes of kidney transplants at our center, focusing on the comparative efficacy and safety profiles of these agents.

Methods:

This retrospective cohort study analyzed data from kidney transplant recipients treated at a tertiary care hospital in India between 2017 and 2024. A total of 603 patients were included, with 381 receiving ATG and 222 receiving ATLG as induction therapy. All patients were maintained on a standard regimen of triple immunosuppressive therapy. Follow-up assessments included evaluations for graft rejection, infections, development of de novo diseases, and overall graft survival.

Results:

The mean follow-up duration was 60 months. The mean doses administered were 5.4 ± 1.4 mg/kg for ATLG and 2.37 ± 1.2 mg/kg for ATG. Baseline demographic and clinical characteristics were well-matched between the two groups. HLA matching showed <3/6 in 95 patients (42.7%) with ATLG and in 318 patients (83.4%) with ATG, while >3/6 HLA matching was found in 127 patients (57.2%) with ATLG and 63 patients (16.5%) with ATG. Serum creatinine levels at discharge and during follow-up intervals were comparable between groups. The incidence of de novo diseases was higher in the ATG group (12 cases, 3.1%) compared to the ATLG group (3 cases, 1.3%). However, the incidence of infections was similar between the two groups.

Table1: Rejection Analysis between (ATLG and ATG)

 

ATG(n=381)

(n=38, Rejection 10%)

ATLG (n=222) (n=24, Rejection 10.7%)

Rejection within 1 month

 

 

Acute Cellular Rejection

7(1.8%)

6(2.7%)

Acute ABMR

NR

NR

Rejection in 1 month to 6 months

    

Acute Cellular Rejection

11(2.8%)

8(3.6%)

Acute ABMR

1(0.2%)

1(0.2%)

Rejection after 6 months

    

Acute Cellular Rejection

9(2.3%)

7(3.1%)

Acute ABMR

10(2.6%)

2(0.9%)

      Difference between two groups p=0.54)

Conclusions:

Both ATG and ATLG demonstrated similar efficacy in terms of short-term and long-term graft rejection rates in kidney transplant recipients. The higher incidence of de novo diseases observed in the ATG group warrants further investigation to determine the underlying mechanisms.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.