Antithymocyte globulin in renal transplant recipients. Report of a prospective randomized controlled trial.

Horse antihuman thymocyte globulin (HAHTG) combined with prednisone and azathioprine (lmuran) was used as immunosuppressive therapy in a randomized controlled sutdy in 50 renal allograft recipients. Side effects of HAHTG administration given intravenously were mostly mild. In the treated group, four patients out of 26 died of infectious complications, whereas in the control group, three patients out of 24 died of infectious complications (chi2 = .01,P greater than .05). The graft survival at 18 months was ten of 24 in the control group and ten of 26 in the treated group (chi2 = 1.26, P greater than .05). Cumulative graft survival was 58.3% in the control group and 38.1% in the treated group at 18 months. However, if we consider the people who died with a functioning graft not as graft failure but as if they left the study, then the cumulative graft survival is 64.5% in the control group and 65.9% in the treated group. Thus, the mortality from infective causes and graft survival were not significantly different between the two groups. Hence, we draw the conclusion that use of HAHTG did not exert a beneficial effect on the ultimate outcome.