Thymoglobulin induction and steroid avoidance in cardiac transplantation: Results of a prospective, randomized, controlled study

Mohamad H. Yamani, David O. Taylor, Jennifer Czerr, Christinna Haire, Richard Kring, Lingmei Zhou, Robert Hobbs, Nicholas Smedira, Randall C. Starling

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Background: Chronic use of corticosteroids (CS) following transplantation is associated with significant long-term morbidities. Minimizing exposure to CS to improve long-term outcomes, without compromising allograft function, remains an important goal in transplantation. Objectives: This single-center, prospective, randomized, open-label study was designed to evaluate the efficacy of Thymoglobulin ® as part of a CS-sparing regimen in cardiac transplantation. Methods: Thirty-two low-risk cardiac transplant patients were randomized in a 1:1 ratio to receive either a Thymoglobulin-based CS-avoidance regimen (CS-avoidance group; n=16) or a long-term CS-based regimen with no antibody induction (control group; n=16). Pulse CS therapy was used for the treatment of acute cellular rejection in both groups. Results: Baseline characteristics were similar between groups. At one yr, there was no significant difference in the mean incidence of acute cellular rejection (≥3A) episodes between the CS-avoidance and control groups, 0.81±1.05 and 1.07±1.03, respectively. Importantly, the CS-avoidance patients had significant improvement in muscle strength and less bone loss compared with the control patients during the first six months post-transplant. Conclusions: CS-avoidance regimen with Thymoglobulin induction appeared to be safe and effective in cardiac transplantation. Further studies are required to demonstrate the long-term safety and benefits of such a regimen.

Original languageEnglish (US)
Pages (from-to)76-81
Number of pages6
JournalClinical Transplantation
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2008

Keywords

  • Cardiac Transplantation
  • Corticosteroids
  • Thymoglobulin

ASJC Scopus subject areas

  • Transplantation

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    Yamani, M. H., Taylor, D. O., Czerr, J., Haire, C., Kring, R., Zhou, L., Hobbs, R., Smedira, N., & Starling, R. C. (2008). Thymoglobulin induction and steroid avoidance in cardiac transplantation: Results of a prospective, randomized, controlled study. Clinical Transplantation, 22(1), 76-81. https://doi.org/10.1111/j.1399-0012.2007.00748.x