Application of antibodies to human lymphocytes for prevention of acute rejection after organ transplantation in patients with chronic kidney failure

Arzumanov S.V., Mitish A.E., Yarovoy S.K., Ufimceva V.Yu., Gramotnev A.K.

The article analyzes the results of application of three schemes of induction immunosuppressive therapy with the use of different drugs ofpoly- and monoclonal antibodies in patients after relative-to-relative transplantation of the kidney.

Materials and methods. The study is based on the results of 107 primary relative-to-relative transplantation of the kidney, which were performed over the period of January, 2012 - March, 2015 in N.A. Lopatkin Research Institute of Urology and Interventional Radiology. The recipients included into the study (107 persons) were subdivided into several groups, according to the type of antibody drugs they were receiving: anti-thymocyte immunoglobulin (Atgam), 10 mg/kg, 7 days; anti-thymocyte immunoglobulin (Thymoglobulin),

1 mg/kg, 7 days; anti-thymocyte immunoglobulin (Atgam), 250 mg perday (irrespectively of body mass) during 4 days in a combination with monoclonal antibodies to human leukocyte interleukin-2 receptor (CD25) produced by Basiliximabum (Simulect), 20 mg per day during

2 days. Furthermore, all patients were receiving tacrolimusum, mycophenolic acid and methylprednisolonum.

Results. According to the frequency of episodes of acute rejection of the graft in early and late post-operative periods, the investigated approaches towards induction immunosuppression in patients after relative-to-relative transplantation have appeared to be commensurate with each other.

A proper safety profile of a four-component system (tacrolimusum, mycophenolic acid, methylprednisolonum and anti-thymocyte immunoglobulin (Thymoglobulin) was noticed, in comparison with other schemes investigated. This profile resides in a significant decrease in the frequency of toxic thrombocytopenia.

Conclusion. It is more preferable to use anti-thymocyte immunoglobulin (Thymoglobulin), 1 mg/kg, during 7 days in nonsensibilized patients after kidney transplantation so as to prevent acute rejection of the graft.

Authors declare lack of the possible conflicts of interests.

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kidney transplantation, antibodies to human lymphocytes, prevention of acute organ transplant rejection

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