Steroid-resistant rejection in kidney-transplanted patients: is ATG treatment for three or ten days preferable?

We carried out a randomized prospective trial to compare a 3-day with a 10-day course of antithymocyte globulin (ATG)-(Fresenius) for treatment of steroid-resistant rejection after renal transplantation. The aim was to study whether a short 3-day course was as safe and effective as the longer 10-day treatment. Thirty patients over a 3-year period were included. Patients that did not respond to treatment after 3 days received additional ATG from day 5 to day 10. The graft survival and the proportion of rejections reversed with the treatment were compared. Fifty percent responded promptly in the 3-day group and a further 29% after additional treatment. In the 10-day group, 62% responded to the treatment. There was no significant difference between the groups. We, therefore, suggest that the standard antirejection treatment with ATG could be shortened without an increased risk of graft failure.