Analysis of infusion-site reactions in renal transplant recipients receiving peripherally administered rabbit antithymocyte globulin as compared with basiliximab

Transpl Int. 2010 Jun;23(6):636-40. doi: 10.1111/j.1432-2277.2009.01042.x. Epub 2010 Jan 13.

Abstract

Antithymocyte globulin rabbit (r-ATG) has been used for the treatment and prevention of acute rejection in renal transplant recipients (RTR). Current manufacturer recommendations for r-ATG dictate the need for administration through a high-flow vein (central line). Previous studies have shown peripheral administration of r-ATG to be safe; however, these studies suggest the co-administration of heparin and hydrocortisone and did not compare the infusion-site reaction rates to a control group. A retrospective analysis was conducted of adult RTR receiving r-ATG or basiliximab between January 2004 and October 2006. Each agent was administered through a dedicated peripheral line. The primary endpoint was the incidence of infusion-site reactions. Other endpoints included the need to replace the intravenous catheter and the incidence of systemic thrombosis within 1 month of transplantation. During the study period, 152 peripheral infusions of r-ATG and 92 peripheral infusions of basiliximab were administered. No difference in infusion-site reactions was noted between the groups. There was also no difference either in the need for peripheral line replacement or the rates of systemic thrombosis. Peripheral administration of r-ATG is safe and can be infused without concomitant heparin and hydrocortisone. This method of r-ATG infusion was shown to be as safe as peripherally administered basiliximab.

MeSH terms

  • Adult
  • Animals
  • Antibodies, Monoclonal / administration & dosage*
  • Antilymphocyte Serum / administration & dosage*
  • Basiliximab
  • Female
  • Graft Rejection / prevention & control*
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Infusions, Intravenous / adverse effects*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Rabbits
  • Recombinant Fusion Proteins / administration & dosage*
  • Retrospective Studies
  • Safety

Substances

  • Antibodies, Monoclonal
  • Antilymphocyte Serum
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Basiliximab