Parvovirus infection in 10 kidney transplant recipients occurred at a median of 2.5 months, universally required IVIG and transfusions, and resulted in 20% graft loss and 10% mortality.
Does the dose of rATG induction therapy affect patient survival and graft outcomes in Filipino kidney transplant recipients?
Filipino kidney transplant recipients who underwent living donor kidney transplant at a tertiary medical center from 2016-2020
High-dose rabbit antithymocyte globulin (rATG) induction therapy (>2.80 mg/kg or >4.34 mg/kg)
Low-dose rATG induction therapy (≤2.80 mg/kg)
Patient survival, renal function, delayed graft function, acute rejection, infection, malignancy, death censored graft failure, and death with functioning grafthard clinical
A cumulative rATG dose >4.34 mg/kg is associated with significantly reduced patient survival in Filipino kidney transplant recipients, establishing a potential upper safety limit for induction therapy.
Absolute Event Rate: 0% vs 0%
Table 1.Baseline characteristic of patients (n=10) Parameter Value Male, % 100 Age (years), median (IQR) 33 (26-44) Basic disease, % FSGS 20 IgA nephropathy 10 Chronic glomerulonephritis 30 Diabetic kidney disease 10 Renal stone disease 10 Obstructive uropathy 10 Unknown 20 First kidney transplant, % 90 Kidney donor, % Living donor 90 Deceased donor 10 ABO compatibility, % ABO compatible 90 ABO incompatible 10 Induction, % R-ATG (Thymoglobulin) 80 ATG-F (Grafalon) 10 No induction 10 FSGS = focal segmental glomerulosclerosis; R-ATG = rabbit antithymocyte globulin; ATG-F = antithymocyte globulin Fresenius.Table 2. Characteristics and Outcomes of Parvovirus Infection (n=10) Parameter Value Time to infection (months), median (IQR) 2.5 (2-10) Time to infection, % < 6 months 70 6-12 months 20 1-5 years 10 Symptoms, % Weakness 100 Fever 30 Sore throat 10 Rejection prior to infection, % 40 Rejection after infection, % 20 Blood result at diagnosis, median (IQR) Hemoglobin (g/dL) 6.0 (5.7-6.9)White blood cell (cells/mL) 4,550 (3,925-6,185) Platelet (cells/mL) 193,000 (176,250-283,000) Urea (mg/dL) 54 (48-89) Creatinine (mg/dL) 2.2 (1.8-3.0)AST (IU/L) 27.5 (23-39.7)ALT (IU/L) 21.5 (14.7-34.2) Lowest hemoglobin during infection (g/dL), median (IQR) 4.9 (3.9-5.3)Bone marrow examination, % 30 Hypocellular 100 Therapy, % IVIG 100 Packed red cell transfusion 100 Erythropoietin 40 HIF-PHDi 20 Tacrolimus switch to Cyclosporin A, % 40 Time to resolution, median (IQR) 12 (10-13) Graft loss, % 20 Death, % 10 AST = aspartate transaminase; ALT = alanine transaminase; IVIG = intravenous immunoglobulin; HIF-PHDi = hypoxia-inducible factor-prolyl hydroxylase inhibitor
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Gular et al. (Wed,) reported a other. Parvovirus infection in 10 kidney transplant recipients occurred at a median of 2.5 months, universally required IVIG and transfusions, and resulted in 20% graft loss and 10% mortality.
synapsesocial.com/papers/69c770888bbfbc51511e08ca — DOI: https://doi.org/10.1016/j.ekir.2026.105460
Wilmark Gular
Brian Michael Cabral
St. Luke's Medical Center
Mary Jane Cabuenos
Kidney International Reports
St. Luke's Medical Center
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