TY - JOUR
T1 - Thymoglobulin induction and steroid avoidance in cardiac transplantation
T2 - Results of a prospective, randomized, controlled study
AU - Yamani, Mohamad H.
AU - Taylor, David O.
AU - Czerr, Jennifer
AU - Haire, Christinna
AU - Kring, Richard
AU - Zhou, Lingmei
AU - Hobbs, Robert
AU - Smedira, Nicholas
AU - Starling, Randall C.
PY - 2008/1
Y1 - 2008/1
N2 - 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.
AB - 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.
KW - Cardiac Transplantation
KW - Corticosteroids
KW - Thymoglobulin
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U2 - 10.1111/j.1399-0012.2007.00748.x
DO - 10.1111/j.1399-0012.2007.00748.x
M3 - Article
C2 - 18251036
AN - SCOPUS:38549103672
SN - 0902-0063
VL - 22
SP - 76
EP - 81
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 1
ER -