RATG is indicated for the treatment of renal transplant acute rejection in conjunction with concomitant immunosuppression. RATG is not currently approved in the U.S. for the primary induction use in renal transplantation. RATG significantly reduced that frequency of reoccurring rejection, particularly those with moderate to severe changes. The recommended route of administration is intravenous infusion through a 0.22-micron filter into a high flow vein. No dosage adjustments are needed in the elderly or patients with renal or hepatic dysfunction.
Adverse effects are generally manageable and reversible.
RATG has been shown to be safe and effective in treating moderate to severe rejection. The most common side effects include leukopenia and thrombocytopenia, which usually reverse with dosage reduction. Rabbit anti-thymocyte globulin should only be used by physicians experienced in immunosuppressive therapy for the management of organ transplant patients. Thymoglobulin was added to the formulary, with the deletion of Atgam. Gaber AO, et al.