Introduction: The two anti-thymocyte globulins- thymoglobulin and grafalon (ATG Fresenius) have been commonly used for induction immunosuppression in kidney transplantation. In this study, we compared the outcomes using these two agents in ABO Incompatible kidney transplants done at our institute.
Methods: This was a single-center retrospective study of ABO-Incompatible kidney transplantations conducted at Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata from November 2022 to March 2023. 14 ABOi transplant recipients were included in each group who received either grafalon or thymoglobulin induction at 6 and 3 mg/kg, respectively. It was followed by standard triple immunosuppression of tacrolimus, MMF and prednisolone. The patients were followed up and compared in terms of graft survival, patient survival, incidences of infection and rejection.
Results: The mean duration of follow up was 14  months. Baseline demographics were similar in both groups. The median discharge creatinine was 1.02 ± 0.27 in grafalon group and 1 ± 0.39 in thymoglobulin group. The creatinine on follow up was 1.37 ± 0.96 and 0.85 ± 0.4 respectively in grafalon and thymoglobulin groups. There was one episode of rejection (ABMR) in grafalon group and ACR in thymoglobulin group. Graft and patient survival was 100 % in both the groups. Incidence of infection was also comparable between the two groups.
Conclusion: Thymoglobulin and Grafalon in dose of 3 and 6 mg/kg respectively were found to be comparable in terms of short term graft survival, patient survival, incidences of infection and rejection.