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Induction therapy in kidney transplants is initiated in immunologically high risk patients.The therapy prevents the episodes of rejection and helps in graft survival.Rabbit ATG(Anti thymocyte immunoglobulin)which is commonly instituted is costly and it escalates the overall cost of transplant therapy ,if it can be replaced by cheaper time tested alternative it willl be very useful in developing and poor countries.Horse ATG is an efficacious and affordable option which can be used in these conditions.
We randomised all immunologically high risk patients(cadaver, spousal and approved unrelated transplants)to receive either Horse or Rabbit ATG from June 2023 to December 2023.They received Injection Horse ATG at the dose of 10 mg/kg body weight or 5mg/kg of Rabbit ATG.After induction ,maintenance therapy was continued with tablet prednisolone, mycophenolate mofetil and Tacrolimus.Patients were monitored for any infusion reactions and followed for a period of 3 months till March 2024 .Biopsy proven rejections, infections episodes were recorded.
Fifty two patients were enrolled into the study till date ,of which 25 patients received rabbit ATG and the rest received horse ATG.Biopsy proven rejection episodes were seen in both the groups; 2 in horse ATG group (1 Acute cell mediated and 1 antibody mediated )Both the groups were compared.Both the groups were comparable at age ,sex and further parameters at baseline.After therapy both the groups were seen for reactions.In follow up the groups was also similar for it which were treated, vs 2(acute cell mediated )in rabbit ATG groupAtp== Adr u.It has been noticed that both the groups were comparable in all parameters studied .
Till now the data analysed shows that patients receiving Horse ATG were performing well.There is no statistically significant difference in patients receiving horse vs rabbit ATG.If proven good horse ATG can replace rabbit ATG as a cheaper alternative as the overall cost of induction can be reduced upto one thirds.