Association Between Cumulative Ratg Induction Doses and Kidney Graft Outcomes and Adverse Effects in Kidney Transplant Patients: A Systematic Review and Meta-Analysis Publisher Pubmed



Mohammadi K¹ ; Khajeh B¹ ; Dashtikhavidaki S¹ ; Shabbidar S²
Source: Expert Opinion on Biological Therapy Published:2021

Abstract

Background: This systematic review and meta-analysis were performed to explore the association between rabbit thymoglobulin (rATG) doses and transplant-related efficacy and safety outcomes. Methods: We searched PubMed and Scopus databases from inception up to June 2020. The primary efficacy and safety endpoints in kidney transplant recipients were evaluated. Results: Data of 23 cohort studies (3457 patients) and three RCTs (154 patients) were extracted and analyzed. rATG doses of ≤4.5 m/kg was associated with lower rates of biopsy proven acute rejection, cytomegalovirus infection, BK virus infection, and malignancy with a comparable rate of delayed graft function, patients’ mortality, and death-censored graft loss compared to rATG total doses of 4.5–6 mg/kg or more than 6 mg/kg. The rATG doses of 3–4.5 mg/kg was associated with better outcomes in dose–response analysis. Expert opinion: Cumulative rATG induction doses as much as 3–4.5 mg/kg is as effective as higher doses regarding to allograft and patient outcomes while minimizing potential adverse effects in kidney transplant recipients. © 2021 Informa UK Limited, trading as Taylor & Francis Group.