Rabbit antithymocyte globulin and donor-specific antibodies in kidney transplantation – a review

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 (DSA). In kidney transplant patients with low-strength preformed DSA, 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 DSA, rATG induction with more aggressive desensitization appears effective, with mixed results concerning the addition of B-cell specific agents.
Source: Transplantation Reviews - Category: Transplant Surgery Authors: Source Type: research