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antithymocyte globulin

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New England Journal of Medicine, Volume 378, Issue 25, Page 2450-2450, June 2018.
June 13, 2018: New England Journal of Medicine
Apurva D Patel, Brian Lowes, Mohammed A Chamsi-Pasha, Stanley J Radio, Marshall Hyden, Ronald Zolty
CLINICAL FEATURES: Giant cell myocarditis (GCM) is a rare and a rapidly progressive disorder with fatal outcomes such that patients often require heart transplantation. We present a case of recurrent GCM in a transplanted patient with a history of Crohn disease requiring a novel therapeutic approach. THERAPEUTIC CHALLENGE: After the orthotopic heart transplantation, GCM recurred on aggressive immunosuppression over the months, which included corticosteroids, basiliximab, tacrolimus, antithymocyte globulin, and rituximab...
May 30, 2018: American Journal of Therapeutics
Bruce E Gelb, J Rodrigo Diaz-Siso, Natalie M Plana, Adam Jacoby, William J Rifkin, Kimberly S Khouri, Daniel J Ceradini, Eduardo D Rodriguez
Background: Donor-specific antibodies (DSA) to human leukocyte antigen increase the risk of accelerated rejection and allograft damage and reduce the likelihood of successful transplantation. Patients with full-thickness facial burns may benefit from facial allotransplantation. However, they are at a high risk of developing DSA due to standard features of their acute care. Case Presentation: A 41-year-old male with severe disfigurement from facial burns consented to facial allotransplantation in 2014; panel reactive antibody score was 0%...
2018: Case Reports in Transplantation
B Al-Saud, M Al-Jomaie, A Al-Ghonaium, A Al-Ahmari, H Al-Mousa, S Al-Muhsen, A Al-Seraihy, R Arnaout, S Elshorbagi, H Al-Dhekri, M Ayas
Hyper-IgM syndrome due to CD40 deficiency (HIGM3) is a rare disease with only a few reported cases of haematopoietic stem cell transplantation (HSCT). In retrospective study, we reviewed all patients with HIGM3 who underwent HSCT at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, between 2008 and 2013. Six patients were identified. Three male and three female patients from three families. The median age of diagnosis was 13 months (range, 1-28 months). All lacked CD40 expression on B cells by flow cytometry...
June 8, 2018: Bone Marrow Transplantation
Nujood Alzahrani, Nshwa Ashor, Traji Fathi, Dania Bukhari, Galila Zaher
Bone marrow transplantation is the definitive treatment of severe aplastic anemia; however, with the absence of this option, combined immunosuppressive therapy with antithymocyte globulin (ATG) and cyclosporine A is used as a first-line therapy. This case report highlights the possible delay in response to ATG protocol in treating aplastic anemia.
June 2018: Clinical Case Reports
Ryan J Butts, Anne I Dipchand, David Sutcliffe, Maria Bano, Vivian Dimas, Robert Morrow, Bibhuti Das, Richard Kirk
This study aims to compare 2 common induction strategies, basiliximab and ATG. Analysis of the ISHLT transplant registry was performed. The database was queried for pediatric heart transplants from January 1, 2000, to June 30, 2015, who had received induction with basiliximab or ATG. Primary end-point was graft survival. Secondary end-points included 1-year survival and 1-year conditional survival. There were 3158 heart transplants who received induction with basiliximab or ATG. The ATG cohort was younger, more likely to have congenital heart disease or be a retransplant, have a higher PRA, longer ischemic time, and been transplanted earlier in the study period (all P<...
June 2018: Pediatric Transplantation
Qipeng Sun, Zhengyu Huang, Honglan Zhou, Minzhuan Lin, Xuefeng Hua, Liangqing Hong, Ning Na, Ruiming Cai, Gang Wang, Qiquan Sun
BACKGROUND/AIMS: Delayed graft function (DGF) is a common complication following kidney transplantation adversely affecting graft outcomes. Donation after brain death followed by circulatory death (DBCD), a novel donation pattern, is expected to correlate with high incidence of DGF. However, little information is available about factors associated with DGF in DBCD. METHODS: A total of 383 kidney transplants from DBCD donation in three institutions were enrolled...
May 30, 2018: Kidney & Blood Pressure Research
Xia Zhang, Zhangzhi Li, Wei Geng, Bin Song, Chucheng Wan
PURPOSE: To investigate the efficacy and safety of umbilical cord blood (UCB) infusion (UCBI) plus immunosuppressive therapy (IST) treatment in comparison to IST treatment, as well as predictive factors for clinical responses, in severe aplastic anemia (SAA) patients. MATERIALS AND METHODS: Totally, 93 patients with SAA were enrolled in this cohort study. In the IST group, rabbit antithymocyte globulin (r-ATG) combined with cyclosporine A (CsA) was administered, while in the IST+UBCI group, r-ATG, CsA, and UCB were used...
July 2018: Yonsei Medical Journal
Cheng Zhang, Pei-Yan Kong, Shiqi Li, Ting Chen, Xun Ni, Yunyan Li, Meiling Wang, Yao Liu, Lei Gao, Li Gao, Xian-Gui Peng, Ai-Hua Sun, Ping Wang, Zhi Yang, Xi Zhang, Cheng Qian
BACKGROUND: Reduced-intensity conditioning (RIC) regimens with low tolerable toxicities have been used for allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the relapse rate by this treatment is high. Treatment of CD19 B-cell relapsed/refractory acute lymphoblastic leukemia (r/r ALL) with allogeneic chimeric antigen receptor-modified T (CAR-T) cells is safe and effective. Use of allogeneic CD19-CAR-T cells as a part of RIC regimens for treatment of r/r ALL patients with haploidentical HSCT has not been investigated yet...
July 2018: Journal of Immunotherapy
Sophia Lionaki, Eystratios Tsakonas, Athina Androulaki, George Liapis, Panagiotis Panayiotidis, George Zavos, John N Boletis
This is a case of a renal transplant recipient who developed a primary hepatic Burkitt lymphoma a few years after kidney transplantation. The past medical history of the patient was significant for anti-HCV positivity with liver histopathology showing minimal changes of grades 0 and 1, stage 0. She received a graft from a deceased donor, with rabbit antithymocyte globulin and methyl-prednisolone, as induction therapy, and was maintained on azathioprine, cyclosporine, and low dose methyl-prednisolone with normal renal function...
2018: Case Reports in Nephrology
Markus J Barten, Uwe Schulz, Andres Beiras-Fernandez, Michael Berchtold-Herz, Udo Boeken, Jens Garbade, Stephan Hirt, Manfred Richter, Arjang Ruhpawar, Tim Sandhaus, Jan Dieter Schmitto, Felix Schönrath, Rene Schramm, Martin Schweiger, Markus Wilhelm, Andreas Zuckermann
Donor-specific antibodies (DSA) are integral to the development of antibody-mediated rejection (AMR). Chronic AMR is associated with high mortality and an increased risk for cardiac allograft vasculopathy (CAV). Anti-donor HLA antibodies are present in 3-11% of patients at the time of heart transplantation (HTx), with de novo DSA (predominantly anti-HLA class II) developing post-transplant in 10-30% of patients. DSA are associated with lower graft and patient survival after HTx, with one study suggesting a three-fold increase in mortality in patients who develop de novo DSA (dnDSA)...
May 8, 2018: Transplantation Reviews
Geovana Basso, Claudia Rosso Felipe, Marina Pontello Cristelli, Juliana Mansur Siliano, Laila Viana, Alexandra Nicolau Ferreira Brigido, Suelen Bianca Stopa Martins, Daniel Wagner de Castro Lima Santos, Wilson Ferreira Aguiar, Helio Tedesco-Silva Junior, Jose Osmar Medina-Pestana
The use of mTOR inhibitors is associated with lower incidence of CMV infections but its effect on viral load has not been investigated. This post-hoc analysis included data from 273 CMV seropositive kidney transplant recipients randomized to receive anti-thymocyte globulin and everolimus (rAGT/TAC/EVR, n=81), basiliximab and everolimus (BAS/TAC/EVR, n=97) or basiliximab and mycophenolate (BAS/TAC/MPS, n=95). All patients received tacrolimus (TAC) and corticosteroids. Preemptive CMV therapy based on weekly pp65 antigenemia test was used during the first 6 months...
May 24, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Elisabetta Metafuni, Patrizia Chiusolo, Simona Sica, Luca Laurenti, Stefania Bregante, Maria Teresa Van Lint, Alida Dominietto, Emanuele Angelucci, Andrea Bacigalupo
We studied 97 patients who developed cytomegalovirus (CMV) viremia following an allogeneic hemopoietic stem cell transplant (HSCT) between 2010 and 2015, treated with foscarnet, with the aim of assessing efficacy and safety. The donor was unrelated in 30 patients (UD) and a family HLA-haploidentical donor (HAPLO) in 67 patients: the former (UD) received a prophylaxis for graft-versus-host disease (GvHD), based on antithymocyte globulin (ATG); the latter (HAPLO) received GvHD prophylaxis, based on post-transplant cyclophosphamide (PT-CY)...
May 24, 2018: Bone Marrow Transplantation
Martin Schweiger, Andreas Zuckermann, Andres Beiras-Fernandez, Michael Berchtolld-Herz, Udo Boeken, Jens Garbade, Stephan Hirt, Manfred Richter, Arjang Ruhpawar, Jan Dieter Schmitto, Felix Schönrath, Rene Schramm, Uwe Schulz, Markus J Wilhelm, Markus J Barten
Pediatric heart transplantation (pHTx) represents only a small proportion of cardiac transplants. Due to these low numbers, clinical data relating to induction therapy in this special population are far less extensive than for adults. Induction is used more widely in pHTx than in adults, mainly because of early steroid withdrawal or complete steroid avoidance. Antithymocyte globulin (ATG) is the most frequent choice for induction in pHTx, and rabbit antithymocyte globulin (rATG, Thymoglobulin®) (Sanofi Genzyme) is the most widely-used ATG preparation...
May 15, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Hiroaki Nagata, Takahiro Fujino, Ayako Muramatsu, Yuka Kawaji, Kodai Kuriyama, Muneo Oshiro, Yoshiko Hirakawa, Toshiki Iwai, Hitoji Uchiyama
Rabbit antithymocyte globulin (ATG) is an effective immunosuppressive therapy for patients with aplastic anemia (AA). However, Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) is a rare but serious complication of the therapy. An 81-year-old man was diagnosed with severe AA on the occasion of melena. Because cyclosporine monotherapy did not improve his condition, rabbit ATG was additionally administered. Thirty-one days after the administration of rabbit ATG, the patient presented with fever and general malaise...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Kiran Gajurel, Reshika Dhakal, Stan Deresinski
PURPOSE OF REVIEW: Unlike immunocompetent hosts, solid organ transplant (SOT) recipients with posttransplant histoplasmosis (PTH) often present with disseminated disease and have an attributable mortality of approximately 10%. In this review, we discuss currently available diagnostic tests and treatment strategies in PTH. RECENT FINDINGS: None of the available tests have a 100% diagnostic accuracy. Histoplasma antigen assays are the most sensitive commercially available tests...
May 5, 2018: Current Opinion in Infectious Diseases
Jonathan Fridell, Richard Mangus, Jeanne Chen, Tim Taber, Arianna E Cabrales, Asif Sharfuddin, Muhammad Yaqub, John Powelson
Graft survival following pancreas transplant alone (PTA) is inferior to other pancreas transplants. Steroid elimination is appealing, but a two drug maintenance strategy may be inadequate. Additionally, recipients tend to have diabetic nephropathy and do not tolerate nephrotoxic medications. A three-drug maintenance strategy permits immunosuppression through different mechanisms as well as an opportunity to use lower doses of the individual medications. Induction consisted of five doses of rabbit antithymocyte globulin (1 mg/kg/dose)...
May 8, 2018: American Journal of Transplantation
S D Hwang, J H Lee, S W Lee, K-M Park, J K Kim, M-J Kim, J H Song
BACKGROUND: Rejection and infection can occur after kidney transplantation and are important factors in preserving graft kidney function. The use of immunosuppressant agents in transplantation is therefore important, and the question of which induction therapy should be used as an immunosuppressant is controversial. OBJECTIVE: The goal of this study was to assess the comparative benefits and harms of various maintenance immunosuppressive induction agents in adults undergoing kidney transplantation by using a network meta-analysis and to generate rankings of the different immunosuppressive regimens according to their safety and efficacy...
May 2018: Transplantation Proceedings
Shao-Fen Lin, Su Liu, Hong-Man Xue, Jun-Bin Huang, Jian Wang, Qi-Hui Chen, Bi-Hong Zhang, Chun Chen
In this study, efficacy and safety of two different dosages of rabbit antithymocyte globulin (r-ATG) combined with cyclosporine (CsA) in treating children with severe aplastic anemia (SAA) were compared. The clinical data of 122 SAA children treated by r-ATG/CsA between Jan 2005 and Jan 2017 at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively analyzed. The r-ATG dose of 55 cases was 2.5mg/(kg·d, group 1), and in the other 67 cases it was 3.5 mg/(kg·d, group 2). r-ATG was continuously administered for 5 days...
May 1, 2018: Die Pharmazie
Nadine Müller-Calleja, Svenja Ritter, Anne Hollerbach, Tanja Falter, Karl J Lackner, Wolfram Ruf
The complement and coagulation cascades interact at multiple levels in thrombosis and inflammatory diseases. In venous thrombosis, complement factor 3 (C3) is crucial for platelet and tissue factor (TF) procoagulant activation dependent on protein disulfide isomerase (PDI). Furthermore, C5 selectively contributes to the exposure of leukocyte procoagulant phosphatidylserine (PS), which is a prerequisite for rapid activation of monocyte TF and fibrin formation in thrombosis. Here, we show that monoclonal cofactor-independent antiphospholipid antibodies (aPLs) rapidly activate TF on myelomonocytic cells...
May 8, 2018: Blood Advances
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