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Rabbit antithymocyte globulin and donor-specific antibodies in kidney transplantation - A review.

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dc.contributor.author Pascual Santos, Julio
dc.contributor.author Zuckermann, Andreas
dc.contributor.author Djamali, Arjang
dc.contributor.author Hertig, Alexandre
dc.contributor.author Naesens, Maarten
dc.date.accessioned 2016-04-29T08:14:24Z
dc.date.issued 2016
dc.identifier.citation Pascual J, Zuckermann A, Djamali A, Hertig A, Naesens M. Rabbit antithymocyte globulin and donor-specific antibodies in kidney transplantation - A review. Transplant Rev (Orlando). 2016 Apr;30(2):85-91. doi: 10.1016/j.trre.2015.12.002
dc.identifier.issn 0955-470X
dc.identifier.uri http://hdl.handle.net/10230/26227
dc.description.abstract The mode of action of rabbit antithymocyte globulin (rATG) includes preferential inhibition of pre-existing donor-reactive memory T-cell reconstitution and possibly apoptosis of plasma cells, the source of donor specific antibodies (DSAs). In kidney transplant patients with low-strength preformed DSAs, non-comparative data have shown a low incidence of antibody-mediated rejection (ABMR) and graft survival using rATG even without desensitization procedures. For high strengths of preformed DSAs, rATG induction with more aggressive desensitization appears effective, with mixed results concerning the addition of B-cell specific agents. Regarding production of de novo DSA (dnDSA), interpretation of retrospective analyses is limited by selective use of rATG in higher-risk patients. Observational data in moderately sensitized kidney transplant patients suggest that the incidence of dnDSA and ABMR is significantly lower with rATG versus basiliximab. A randomized pilot study has suggested that addition of rituximab or bortezomib may not further inhibit dnDSA production in rATG-treated patients. Overall, rATG appears to inhibit DSA production, with a potential role in reducing the risk of ABMR in kidney transplant patients with high-strength preformed DSA, or lowering dnDSA in moderately sensitized patients. Randomized trials are awaited.
dc.description.sponsorship Julio Pascual is supported by grants PI13/00598 (Spanish Ministry of Health ISCIII FIS-FEDER), Marato TV3 137/C/2012 and RedinRen RD12/ 0021/0024. Medical writing support was funded by a grant from Sanofi. Conflicts of interest: Dr. Julio Pascual has received honoraria from Sanofi. Andreas Zuckermann is a member of a speaker's bureau and advisory board for Sanofi, is a member of a speaker's bureau for Novartis, and has received a scientific grant from Roche. Arjang Djamali has received travel support from Sanofi and grants from BMS and Takeda. Alexandre Hertig has received speaker's honoraria from Sanofi, Novartis and Astellas. Maarten Naesens is a member of advisory boards for Roche, Novartis and Sanofi, has received speaker's honoraria from Novartis, Astellas and Shire, and has received travel support from Sanofi, Novartis and Astellas
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Transplantation Reviews (Orlando). 2016 Apr;30(2):85-91
dc.rights Copyright © 2016 Elsevier. Licensed under de Creative Commons Attribution-NonCommercial-NoDerivatives 4.= International http://creativecommons.org/licenses/by-nc-nd/4.0/ http://dx.doi.org/10.1016/j.trre.2015.12.002
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.other Ronyons -- Trasplantació -- Aspectes immunològics
dc.title Rabbit antithymocyte globulin and donor-specific antibodies in kidney transplantation - A review.
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.trre.2015.12.002
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion


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