Hardinger Karen L, Rasu Rafia S, Skelton Rebecca, Miller Brent W, Brennan Daniel C
Division of Pharmacy Practice and Administration, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
J Transplant. 2010;2010:957549. doi: 10.1155/2010/957549. Epub 2010 Nov 7.
The optimal dose and duration of rabbit antithymocyte globulin (rATG) induction has not been defined. Methods. We compared the safety and efficacy of 2 dosing strategies, rATG 1.5 mg/kg for 4 days (n = 59) versus 2 mg/kg for 3 days (n = 59), in a retrospective, cohort study. Results. Two-year rejection-free survival was 95% in each group (P = .983). Renal function and infection rates were similar. The incidence of leucopenia was similar, although the 2 mg/kg group was more likely to be thrombocytopenic on day 2 (4% versus 28%, P = .04). Length of stay tended to be longer for the 1.5 mg/kg group (6.0 ± 3.7 versus 5.1 ± 1.9 days P = .104). A cost savings of $920 per patient for rATG were seen in the 2 mg/kg group (P = .122). Conclusions. Shorter, more intense dosing of rATG is safe and effective. The 3-day dose strategy resulted in a clinically shorter length of stay and may result in cost savings.
兔抗胸腺细胞球蛋白（rATG）诱导治疗的最佳剂量和疗程尚未确定。方法。在一项回顾性队列研究中，我们比较了两种给药方案的安全性和有效性，即rATG 1.5mg/kg，共4天（n = 59）与2mg/kg，共3天（n = 59）。结果。两组的两年无排斥生存率均为95%（P = 0.983）。肾功能和感染率相似。白细胞减少症的发生率相似，尽管2mg/kg组在第2天更易出现血小板减少（4%对28%，P = .04））。1.5mg/kg组的住院时间往往更长（6.0±3.7天对5.1±1.9天，P = 0.104）。2mg/kg组每位患者的rATG成本节省了920美元（P = 0.122）。结论。更短、强度更大剂量的rATG是安全有效的。3天剂量方案导致临床住院时间缩短，可能节省成本。
