#2362 Clinical utility Anti-human T-lymphocyte Immunoglobulin (ATLG) as an induction agent in a living donor kidney transplantation: 5-year follow-up data

Background and Aims The usage of induction agents for living donor kidney transplants in India is varied. Polyclonal antibodies currently in use are anti-thymocyte globulin (ATG) and anti-T-lymphocyte globulin (ATLG). The role and dose of ATLG need to be defined. This study is focused on ATLG usage and the outcome with long-term follow-up. Method This is an analysis of 206 patients who received ATLG as an induction agent from 2017 to 2023. Patients received triple immunosuppression therapy: Tacrolimus, Mycophenolate Mofetil (MMF), and prednisolone for maintenance immunosuppression. Results A total of 206 patients received ATLG as an induction agent for living donor kidney transplants. The mean age of the patients was 39.13 ± 12.56 years. There were 87.3% (n = 180) males and 12.6% (n = 26) females. The majority of transplants in our study were ABO-compatible (94.6%, n = 195) and ABO-incompatible (5.2%, n = 11). The mean age of donors was 41 ± 13.7 years. Males were 38.3% (n = 79), and females were 61.6% (n = 127). Overall survival observed in the current study was 98% (n = 202), Post-transplant, 4 patients died (n = 2 died due to COVID-19, 1 due to Heart failure and 1 was infectious mortality.) The mean cumulative dose of ATLG in the current study was 305.1 ± 61.8 mg, and the mean dose was 5.4 ± 1.4 mg/kg. The baseline etiologies of patients who underwent transplant were chronic glomerulonephritis (47.5% n = 98), diabetic nephropathy (16.9% n = 35), hypertension (29.1% n = 60), CIN, and other GMB diseases. In the current study, the figure shows overall 11.6% (n = 24) rejections and 5-year follow-up data of Serum creatinine within a normal range. Post-transplant BK Virus Nephropathy was observed in 3.39% (n = 7) cases, CMV infection in two cases, TB was observed in three cases and fungal pneumonia in one case. Conclusion Long-term 5 year follow-up of Living donor kidney transplant shows that ATLG is an effective and safe induction agent. Good compliance with Oral immunosuppressant can improve graft survival as per the current study.