Objective To investigate the efficacy and safety of antithymocyte globulin (ATG) in the immune induction of deceased donor renal re-transplantation. Methods The clinical data of 20 renal re-transplantation patients treated with ATG from June 2017 to November 2020, were retrospectively studied. The safety was assessed with T lymphocyte subsets, pulmonary infection, and bone marrow suppression. The efficacy was assessed with acute rejection (AR) and delayed graft function (DGF). Results The study contained 15 males and 5 females. The average age was 45.7 (25-71) years; 6 patients were positive for prestored antibody and 14 negative antibody; 17 patients received a second transplantation, 3 did a third transplantation. T lymphocytes decreased more than 70% in average induced by ATG on the 1st day after surgery and gradually recovered to 50% of the amount on the 3rd day after surgery (P<0.01). Two weeks after surgery, the number of T lymphocytes recovered to the pretransplant level. NK cells showed a continuous decline (P<0.01). There were 5 patients (25.0%) who suffered AR, 1 patient (5.0%) did DGF, 7 patients(35.0%) presented with pulmonary infection, 5 patients (25.0%) presented with bone marrow suppression, and no ATG allergic reaction cases. The median follow-up period was 17.6 (6-53) months. During the follow-up period, 19 patients (95.0%) survived with allograft and 1 (5.0%) died. Conclusions ATG can significantly suppress the activation and proliferation of T cells, reduce the incidence of AR, and improve the short-term functional recovery of allograft with kidney re-transplantation. ATG induction does not increase the incidence of infection, and the clinical safety of ATG application is reliable.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |