Comparison of polyclonal induction agents in pediatric renal transplantation
dc.contributor.author | Brophy, Patrick D. | en_US |
dc.contributor.author | Thomas, Susan E. | en_US |
dc.contributor.author | McBryde, Kevin D. | en_US |
dc.contributor.author | Bunchman, Timothy E. | en_US |
dc.date.accessioned | 2010-06-01T21:26:50Z | |
dc.date.available | 2010-06-01T21:26:50Z | |
dc.date.issued | 2001-06 | en_US |
dc.identifier.citation | Brophy, Patrick D.; Thomas, Susan E.; McBryde, Kevin D.; Bunchman, Timothy E. (2001). "Comparison of polyclonal induction agents in pediatric renal transplantation." Pediatric Transplantation 5(3): 174-178. <http://hdl.handle.net/2027.42/74506> | en_US |
dc.identifier.issn | 1397-3142 | en_US |
dc.identifier.issn | 1399-3046 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/74506 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=11422819&dopt=citation | en_US |
dc.description.abstract | Collective pediatric data suggest that anti-T-cell induction therapy with polyclonal antibodies improves the outcome of both short- and long-term renal allograft survival. Polyclonal agents, including thymoglobulin (Thy), a rabbit anti-thymocyte globulin; Minnesota (horse) anti-lymphoblast globulin (ALG); and ATGAM, a horse anti-thymocyte globulin (ATG), all suppress B and T cells. While no specific T-cell subset marker exists to measure the adequacy of immunosuppression with polyclonal induction, flow cytometric analysis has been used to evaluate the suppression of CD3, CD4, and CD8 cells. Thy is currently undergoing pediatric trials at our center, and we have utilized ATG and ALG in previous pediatric induction protocols. ALG (20 mg kg day) and ATG (15 mg kg day) were administered over 10 days, whereas Thy (2 mg kg day) was given over 5 days. All inductions were accompanied by preoperative intravenous solumedrol (10 mg kg) followed by oral prednisone (2 mg kg day) with taper. Preoperative (1.5 mg kg day) and post-operative (2 mg kg day) azathioprine was administered to patients receiving ALG or ATG. Mycophenolate mofetil (MMF) (1200 mg m 2 day) was given to the patients receiving Thy. Post-operative cyclosporin A (CsA) (14 mg kg day) was started (for all groups) once renal function permitted (creatinine < 50% of baseline with brisk urine output) (trough goal 150 250 ng mL via HPLC). Values for CD3, CD4, and CD8 T cells were determined by flow cytometry in 2 18-yr-old renal transplant recipients, comparing the polyclonal induction agent utilized Thy (n 8), mean age 9.7 2.3 yr; ATG (n 13), mean age 10.1 4.1 yr; and ALG (n 9), mean age 9.3 3.7 yr over days 2 10 post-induction. Data were expressed as the average percentage of cells remaining relative to the baseline T-cell subsets (day 1 100%), because of the large age variation present in basal T-cell subset values. The flow cytometric data suggest that 5 days of Thy appears to give an equal or greater peripheral blood T-cell suppression by day 10 than a 10-day course of either ATG or ALG. | en_US |
dc.format.extent | 69978 bytes | |
dc.format.extent | 3109 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Munksgaard International Publishers | en_US |
dc.publisher | Blackwell Publishing Ltd | en_US |
dc.rights | Munksgaard | en_US |
dc.subject.other | Pediatric Renal Transplantation | en_US |
dc.subject.other | Polyclonal Induction | en_US |
dc.subject.other | T Cells | en_US |
dc.title | Comparison of polyclonal induction agents in pediatric renal transplantation | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Pediatrics | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Pediatric Nephrology and Transplantation, CS Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA, | en_US |
dc.contributor.affiliationother | Pediatric Nephrology, Children's Hospital of Alabama, University of Alabama, Birmingham, Alabama, USA | en_US |
dc.identifier.pmid | 11422819 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/74506/1/j.1399-3046.2001.00054.x.pdf | |
dc.identifier.doi | 10.1034/j.1399-3046.2001.00054.x | en_US |
dc.identifier.source | Pediatric Transplantation | en_US |
dc.identifier.citedreference | Benfield MR, McDonald R, Sullivan EK, Stablein DM, Tejani A. The 1997 Annual Renal Transplant-ation in Children Report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Pediatr Transpl 1999: 3: 152 167. | en_US |
dc.identifier.citedreference | Ettenger RB. Special considerations in pediatric renal transplantation. In: Norman DJ, Suki WN, eds. Primer on Transplantation. New Jersey: American Society of Transplant Physicians, 1999: 251 264. | en_US |
dc.identifier.citedreference | Bunchman TE. Flow cytometry: its use in pediatric renal transplantation utilizing polyclonal induction. Cytom-etry (Comms Clin Cytometry) 1995: 22: 16 21. | en_US |
dc.identifier.citedreference | Bartosh SM, Brophy PD, Hmiel P, Bunchman TE. Thymoglobulin induction in pediatric renal transplantation (Abstr.). First Congress of the International Pediatric Transplant Association. Venice, Italy, 2000. | en_US |
dc.identifier.citedreference | Bell L, Girardin C, Sharma A, Goodyer P, Mazer B. Lymphocyte subsets during and after rabbit anti-thymocyte globulin induction in pediatric renal transplantation: sustained T cell depletion. Transplant Proc 1997: 29: 6S 9S. | en_US |
dc.identifier.citedreference | Bourdage JS & Hamlin DM. Comparative polyclonal antithymocyte globulin and antilymphocyte antilymphoblast globulin anti-CD antigen analysis by flow cytometry. Transplantation 1995: 59: 1194 1200. | en_US |
dc.identifier.citedreference | Bunchman TE, Kershaw DB, Merion RM, et al. OKT3 reversal of biopsy-proven allograft rejection occurring during MALG induction in the pediatric renal recipient. Clin Transpl 1993: 7: 219 222. | en_US |
dc.identifier.citedreference | Buchler M, Thibault G, al Najjar A, et al. Monitoring of ATG therapy by flow cytometry and lymphocyte counts in renal transplantation. Transplant Proc 1996: 28: 2817 2818. | en_US |
dc.identifier.citedreference | Wagner FM, Tugtekin SM, Matschke K, Platzbecker U, Gulielmos V, Schuler S. Flow cytometry-controlled induction therapy with ATG and noninvasive monitoring of rejection a modern management concept after heart transplantation. Lagenbecks Archiv fur Chirurgie 1998: Suppl. 115: 1566 1567. | en_US |
dc.identifier.citedreference | Cinti P, Cocciolo P, Evangelista B, et al. OKT3 prophy-laxis in kidney transplant recipients: drug monitoring by flow cytometry. Transplant Proc 1996: 28: 3214 3216. | en_US |
dc.identifier.citedreference | Shanahan T. Application of flow cytometry in transplantation medicine. Immunol Invest 1997: 26: 91 101. | en_US |
dc.identifier.citedreference | Filo RS, Book B, Pescovitz MD, Milgrom ML, Leapman SB. Association of sensitization to horse antilymphocyte thymocyte globulin with recipient age and decreased renal allograft survival rates. Transplant Proc 1993: 25: 577 580. | en_US |
dc.identifier.citedreference | Birkeland SA. Steroid-free immunosuppression after kidney transplantation with antithymocyte globulin induction and cyclosporine and mycophenolate mofetil maintenance therapy. Transplantation 1998: 66: 1207 1210. | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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