@article{0125dda985994d92a5ce270a10bf1734,
title = "Relationship between antithymocyte globulin, T cell phenotypes, and clinical outcomes in pediatric kidney transplantation",
abstract = "Depletional induction using antithymocyte globulin (ATG) reduces rates of acute rejection in adult kidney transplant recipients, yet little is known about its effects in children. Using a longitudinal cohort of 103 patients in the Immune Development in Pediatric Transplant (IMPACT) study, we compared T cell phenotypes after ATG or non-ATG induction. We examined the effects of ATG on the early clinical outcomes of alloimmune events (development of de novo donor specific antibody and/or biopsy proven rejection) and infection events (viremia/viral infections). Long-term patient and graft outcomes were examined using the Scientific Registry of Transplant Recipients. After ATG induction, although absolute counts of CD4 and CD8 T cells were lower, patients had higher percentages of CD4 and CD8 memory T cells with a concomitant decrease in frequency of na{\"i}ve T cells compared to non-ATG induction. In adjusted and unadjusted models, ATG induction was associated with increased early event-free survival, with no difference in long-term patient or allograft survival. Decreased CD4+ na{\"i}ve and increased CD4+ effector memory T cell frequencies were associated with improved clinical outcomes. Though immunologic parameters are drastically altered with ATG induction, long-term clinical benefits remain unclear in pediatric patients.",
keywords = "clinical research/practice, immune regulation, immunosuppressant - polyclonal preparations: rabbit antithymocyte globulin, immunosuppression/immune modulation, kidney transplantation/nephrology, pediatrics, translational research/science",
author = "Shaw, {Brian I.} and Lee, {Hui Jie} and Cliburn Chan and Robert Ettenger and Paul Grimm and Meghan Pearl and Reed, {Elaine F.} and Robien, {Mark A.} and Minnie Sarwal and Linda Stempora and Barry Warshaw and Congwen Zhao and Martinez, {Olivia M.} and Kirk, {Allan D.} and Chambers, {Eileen T.}",
note = "Funding Information: This research was performed as a project of the Clinical Trials in Organ Transplantation in Children, a collaborative clinical research project headquartered at the National Institute of Allergy and Infectious Diseases. This study was funded by the National Institute of Allergy and Infectious Disease (U01 AI077821 and U01 AI135947). Research reported in this publication was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002553. We would also like to thank all of the patients and their families that participated in the Immune Development in Pediatric Transplantation study. The data reported here have been supplied by the Hennepin Healthcare Research Institute (HHRI) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. Funding Information: This research was performed as a project of the Clinical Trials in Organ Transplantation in Children, a collaborative clinical research project headquartered at the National Institute of Allergy and Infectious Diseases. This study was funded by the National Institute of Allergy and Infectious Disease (U01 AI077821 and U01 AI135947). Research reported in this publication was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002553. We would also like to thank all of the patients and their families that participated in the Immune Development in Pediatric Transplantation study. The data reported here have been supplied by the Hennepin Healthcare Research Institute (HHRI) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. Publisher Copyright: {\textcopyright} 2020 The American Society of Transplantation and the American Society of Transplant Surgeons",
year = "2021",
month = feb,
doi = "10.1111/ajt.16263",
language = "English",
volume = "21",
pages = "766--775",
journal = "American Journal of Transplantation",
issn = "1600-6135",
number = "2",
}