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Effectiveness of Antithymocyte Globulin Induction Dosing Regimens in Kidney Transplantation Patients: A Network Meta-analysis

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Author(s)
Jin Ho LeeKwang Yong KimJoon Ho SongJong Hyun JheeYoon Ji KimWoo Yeong ParkJoong Kyung KimSeoung Woo LeeSeun Deuk Hwang
Keimyung Author(s)
Park, Woo Young
Department
Dept. of Internal Medicine (내과학)
Journal Title
Transplantation proceedings
Issued Date
2019
Volume
51
Issue
8
Abstract
Background:
Antithymocyte globulin (ATG) is an induction therapy in kidney transplantation, but our knowledge about the relation between outcomes and ATG regimens is limited. We compared ATG effectiveness in kidney transplantation according to dosage and administration schedule.

Methods:
Reports from 1970 until May 2018 in CENTRAL, MEDLINE, EMBASE, and Science Citation Index Expanded were searched. We performed direct and indirect network meta-analysis using Bayesian models and generated rankings for ATG dosage and injection number variations by generation mixed treatment comparison.We compared ATG dose and schedule in kidney transplantation in relation to all-cause death, graft failure, antibody-mediated rejection, T-cell mediated rejection, biopsy-proven acute rejection, and bacterial and viral infection.

Results:
Ten studies (N = 1065) were analyzed by forming 6 groups: ATG alternate doses, 9 mg/kg, 6 mg/kg, and 4.5 mg/kg; single dose, 6 mg/kg, and 4.5 mg/kg; and control. Compared to placebo, ATG regimen variations were not associated with significant differences in survival, viral infection, renal function, or graft survival. ATG regimens 9 and 4.5 mg alternate dosing tended to reduce biopsy-proven acute rejection but without statistical significance. According to the highest rank probability, the 9 mg alternate dosing group had the highest tendency for cytomegalovirus and bacterial infections but without statistical significance.

Conclusions:
The rejection frequency tended to be lower for the 9 and 4.5 mg alternate dosing groups. Infections occurred at a higher rate in the 9 mg alternate dosing group, but the differences in the risk of infection among the groups with different ATG regimens were not statistically significant.
Keimyung Author(s)(Kor)
박우영
Publisher
School of Medicine (의과대학)
Citation
Jin Ho Lee et al. (2019). Effectiveness of Antithymocyte Globulin Induction Dosing Regimens in Kidney Transplantation Patients: A Network Meta-analysis. Transplantation proceedings, 51(8), 2606–2610. doi: 10.1016/j.transproceed.2019.04.079
Type
Article
ISSN
1873-2623
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0041134519302751
DOI
10.1016/j.transproceed.2019.04.079
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42417
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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