Impact of Peripheral Rabbit Anti-Thymocyte Globulin Without Heparin and Hydrocortisone Additives on Local Infusion...

Area of Science:

• Nephrology
• Immunosuppression Therapy
• Transplantation Medicine

Background:

• Rabbit anti-thymocyte globulin (rATG) is crucial for induction immunosuppression in renal transplant recipients.
• Heparin and hydrocortisone are traditionally added to peripheral rATG to mitigate infusion reactions.
• Additives were removed from rATG preparations to prevent waste during drug shortages.

Purpose of the Study:

• To evaluate the incidence of local infusion reactions in renal transplant recipients receiving peripheral rATG with and without heparin/hydrocortisone additives.

Main Methods:

• A single-center, retrospective cohort study compared adult renal transplant recipients receiving peripheral rATG.
• Patients were analyzed based on whether their rATG preparation included heparin and hydrocortisone additives.
• The primary outcome was the incidence of local infusion reactions, analyzed using descriptive statistics and Fisher's exact test.

Main Results:

• 261 peripheral rATG doses were analyzed; 120 with additives and 141 without.
• Local infusion reactions occurred in 8.3% of infusions with additives versus 5.7% without.
• No statistically significant difference in local infusion reaction rates was observed between groups (P=.398).

Conclusions:

• Peripheral rATG induction therapy without heparin and hydrocortisone additives shows a similar incidence of local infusion reactions compared to preparations with additives.
• These findings suggest that additives may not be necessary for peripheral rATG infusions.
• Further research is recommended to confirm these results and guide clinical practice.