The Anti-thymocyte Globulin use makes kidney transplantation journey smooth

  • Akbar Mahmood Sultan Qaboos University Hospital, Oman
  • Tanveer Ahmed Sultan Qaboos University Hospital, Oman
  • Kunwar Muhammad Aqeel Karachi Institute of Heart Disease, Pakistan
  • Muhammad Imran Ziauddin University, Pakistan
  • Nosheen Anwer Agha Khan University Hospital, Pakistan
Keywords: Kidney Transplantation, Induction Agents, Anti-thymocyte Globulin (ATG), Allograft, Immunosuppressant Agents.

Abstract

Background: The most common immunosuppressant, Anti-thymocyte Globulin (ATGs) has been widely used by clinicians for the treatment and prevention of rejection at the time of organ transplant. Transplantation is the best option for the people with renal failure at end stage, requiring replacement of renal therapy. This is a promising treatment option with significant benefits in terms of mortality and morbidity. ATG prevents organ rejection by inhibition of activated T-cells and other immune and non-immune cells. The aim of the study was to compare different induction regimens with ATG for the survival of smooth kidney transplantation.

Methodology: Studies of the last 20 years, focusing on kidney transplantation and the efficacy of anti-thymocyte use for kidney transplantation were reviewed for the study literature. The keywords used were Kidney Transplantation, Induction agents, ATG, Allograft, Immunosuppressant Agents.

Results: Literature suggested that the most important problem with transplantation is the protection of the allograft from activated immunological forces, which begin to react early in the period after transplantation and cause significant damage with serious short-term and long-term consequences. This process is called rejection, which is usually classified as cell-mediated and antibody-mediated rejection. The phenomenon mediated by cells causes concern, as it is the cause of future failures and damage to the allograft. To combat these phenomena with different results, various strategies were adopted. Among these therapies, ATG has recognized the exceptional importance of preventing cellular mediated rejection, allowing allotransplants to function smoothly with the greatest possible long-term benefits.

Conclusion: It can be concluded on the basis of previous studies that ATG as an induction agent, is more efficient in reducing the rejection rate in the renal transplantation as compared with other agents.

References

Robinson BM, Akizawa T, Jager KJ, Kerr PG, Saran R, Pisoni RL. Factors affecting outcomes in patients reaching end-stage kidney disease worldwide: differences in access to renal replacement therapy, modality use, and haemodialysis practices. The Lancet. 2016; 388(10041):294-306.

Butler JA, Roderick P, Mullee M, Mason JC, Peveler RC. Frequency and impact of nonadherence to immunosuppressants after renal transplantation: a systematic review. Transplantation. 2004; 77(5):769-776.

Saran R, Robinson B, Abbott KC, Agodoa LY, Albertus P, Ayanian J, Balkrishnan R, Bragg-Gresham J, Cao J, Chen JL, Cope E. US Renal Data System 2016 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2017; 69(3):7-8.

Collins AJ, Foley RN, Gilbertson DT, Chen SC. United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease Kidney Int Suppl. 2015; 5(1):2-7.

Hardinger KL, Brennan DC. Novel immunosuppressive agents in kidney transplantation. World J Transplant. 2013; 3(4):68.

Published
2018-06-30
How to Cite
Mahmood, A., Ahmed, T., Aqeel, K. M., Imran, M., & Anwer, N. (2018). The Anti-thymocyte Globulin use makes kidney transplantation journey smooth. International Journal of Endorsing Health Science Research (IJEHSR), 6(2), 43-53. https://doi.org/10.29052/IJEHSR.v6.i2.2018.43-53