ABSTRACT
Objective:
To explore the
efficacy and
safety of low-
dose rabbit anti-
human thymocyte globulin (rATG) for induction
therapy of
kidney transplantation (KT) in
children.
Methods:
From October 2018 to May 2021, clinical data were reviewed retrospectively for 77 pediatric KT recipients on a low-
dose rATG induction protocol.Recipient/
graft survival rate, renal
function recovery, acute rejection (AR) and adverse reactions were observed at 1 year post-operation.The postoperative changes of renal function were examined by Friedman’s test; According to the preoperative baseline data, Pearson’s Chi-square or Fisher's exact test was utilized for examining the influencing factors of postoperative AR.
Results:
A total of 16(20.78%) recipients had AR within the first 6 months post-operation.The
incidence of
delayed graft function (DGF) was 14.29%(11/77); The
incidence of severe
infection post-
transplantation 18.18%(14/77), the
infection rate of
BK virus 25.97%(20/77) and the
incidence of
neutropenia 32.47%(25/77).The recipient/
graft survival rate at 1 year post-operation was 97.40%(75/77) and 94.81%(73/77) respectively.
Chi-square test indicated that the
incidence of postoperative
infection in
children with
body weight ≤30 kg and height ≤138 cm was 28.95%(11/38) and 27.50%(11/40) respectively, Both were higher than 7.69%(3/39) and 8.11%(3/37) of
children with
body weight >30 kg and height>138 cm.The difference between groups was statistically significant ( P=0.016 and 0.028).
Conclusions:
Low-
dose rATG is generally excellent in preventing AR in pediatric KT recipients.And the
risk of related AR may be lower.The
infection rate of recipients with decent preoperative development is low.