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Rabbit-Derived Drug Prevents Kidney Transplant Rejection

A study headed by the Washington University transplant nephrology team shows that using a rabbit-derived drug to prevent acute rejection of donated kidneys can reap long-term benefits.

The research, published as a letter authored by Daniel C. Brennan, MD, the director of transplant nephrology and medical director of kidney transplant, in the New England Journal of Medicine, describes a multi-center, international clinical trial comparing two “induction agents,” drugs given to kidney transplant patients who have received donor organs from deceased donors. The agents are given during the first several days after surgery in order to avoid delayed functioning of the organ and to prevent acute rejection.

The recent research found that the agent rabbit antithymocyte globulin was as safe and more effective at preventing acute rejection at one year as another commonly used agent, basiliximab.

The study offers an additional breakthrough – a cost-effective methodology to determine long-term patient results. Researchers wanted to see if the benefits of the drug extended after transplant.

Brennan’s team realized that they had a ready-made, long-term database to use as a basis for the retrospective study of results. All United States transplantation centers are mandated to enter patient outcome data into a database maintained by the Organ Procurement and Transplantation Network (OPTN) annually.

Records of all U.S. patients in the study were matched with their records in the OPTN database. Using the records, Brennan and Schnitzler were able to look at the “triple endpoint” – acute rejection, loss of the donor organ and death – used by the FDA to approve anti-rejection drugs. The team found that after five years, patients who received the rabbit antithymocyte globulin had a lower triple end-point score than patients who had received basiliximab.

In the late 1990s, Daniel C. Brennan, MD, director of transplant nephrology and medical director of kidney transplant, and his team pioneered work on using induction agents to prevent acute rejection.
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