Relationship Between Post-kidney Transplantation Antithymocyte Globulin Therapy and Wound Healing Complications

Overview

Journal Int J Organ Transplant Med

Date 2014 Jul 12

PMID 25013627

Citations 4

Authors

G R Pourmand

S Dehghani

A Saraji

S Khaki

S H Mortazavi

A Mehrsai

H Sajadi

Affiliations

Soon will be listed here.

Abstract

Background: Wound healing disorders are probably the most common post-transplantation surgical complications. It is thought that wound healing disturbance occurs due to antiproliferative effects of immunosuppressive drugs. On the other hand, success of transplantation is dependent on immunosuppressive therapies. Antihuman thymocyte globulin (ATG) has been widely used as induction therapy but the impact of this treatment on wound healing is not fully understood.

Objective: To investigate wound healing complications after ATG therapy in renal transplant recipients.

Methods: The medical records of 333 kidney transplant recipients were assessed for wound healing disorders. Among these patients, 92 received ATG and 5 doses of 1.5 mg/kg ATG along with the standard protocol of drugs.

Results: The mean age of patients was 38.9 years. Of 333 recipients, 92 (23.7%) received ATG; 21 (6.3%) developed wound healing complications. There was a significant relationship between ATG therapy and wound complications (p=0.034). Also, women were more likely to develop wound healing disorders than men (p=0.002). No statistical difference was observed between age and wound healing complication (p=0.28). There was no significant difference between the mean duration of hospitalization between ATG and Non-ATG group (p=0.9).

Conclusion: ATG increases the risk of overall wound complications. It is needed to pay more attention to the patients treated with this immunosuppressant to avoid the risk of re-interventions, lessen the duration of hospitalization and decrease the impairment of graft function.

Citing Articles

Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities.

Khalil M, Al-Ghamdi S, Dawood U, Ahmed Khamis S, Ishida H, Chong V J Transplant. 2022; 2022:6255339.

PMID: 35265364 PMC: 8901320. DOI: 10.1155/2022/6255339.

Effect of subcutaneous tissue depth on outcomes of kidney transplantation.

Ruiz R, Cox T, McKenna G, Onaca N, Testa G, Fernandez H Proc (Bayl Univ Med Cent). 2021; 34(2):237-241.

PMID: 33678955 PMC: 7901397. DOI: 10.1080/08998280.2020.1852835.

A 3-month, Multicenter, Randomized, Open-label Study to Evaluate the Impact on Wound Healing of the Early (vs Delayed) Introduction of Everolimus in De Novo Kidney Transplant Recipients, With a Follow-up Evaluation at 12 Months After Transplant....

Manzia T, Carmellini M, Todeschini P, Secchi A, Sandrini S, Minetti E Transplantation. 2019; 104(2):374-386.

PMID: 31335776 PMC: 7004468. DOI: 10.1097/TP.0000000000002851.

Wound Healing Complications in Kidney Transplant Recipients Receiving Everolimus.

Ueno P, Felipe C, Ferreira A, Cristelli M, Viana L, Mansur J Transplantation. 2016; 101(4):844-850.

PMID: 27490418 PMC: 7228604. DOI: 10.1097/TP.0000000000001392.

References

Furriel F, Parada B, Campos L, Moreira P, Castelo D, Dias V . Pretransplantation overweight and obesity: does it really affect kidney transplantation outcomes?. Transplant Proc. 2011; 43(1):95-9. DOI: 10.1016/j.transproceed.2010.12.027. View

Grim S, Slover C, Sankary H, Oberholzer J, Benedetti E, Clark N . Risk factors for wound healing complications in sirolimus-treated renal transplant recipients. Transplant Proc. 2006; 38(10):3520-3. DOI: 10.1016/j.transproceed.2006.10.065. View

Santora T, Roslyn J . Incisional hernia. Surg Clin North Am. 1993; 73(3):557-70. DOI: 10.1016/s0039-6109(16)46037-8. View

Ho D, Lynch R, Ranney D, Magar A, Kubus J, Englesbe M . Financial impact of surgical site infection after kidney transplantation: implications for quality improvement initiative design. J Am Coll Surg. 2010; 211(1):99-104. DOI: 10.1016/j.jamcollsurg.2010.02.055. View

Srivastava A, Muruganandham K, Vinodh P, Singh P, Dubey D, Kapoor R . Post-renal transplant surgical complications with newer immunosuppressive drugs: mycophenolate mofetil vs. m-TOR inhibitors. Int Urol Nephrol. 2009; 42(2):279-84. DOI: 10.1007/s11255-009-9601-6. View

Ismail H, Kalicinski P, Drewniak T, Smirska E, Kaminski A, Prokurat A . Primary vascular thrombosis after renal transplantation in children. Pediatr Transplant. 1997; 1(1):43-7. View

Flechner S, Zhou L, Derweesh I, Mastroianni B, Savas K, Goldfarb D . The impact of sirolimus, mycophenolate mofetil, cyclosporine, azathioprine, and steroids on wound healing in 513 kidney-transplant recipients. Transplantation. 2003; 76(12):1729-34. DOI: 10.1097/01.TP.0000093502.26208.42. View

Mehrabi A, Fonouni H, Wente M, Sadeghi M, Eisenbach C, Encke J . Wound complications following kidney and liver transplantation. Clin Transplant. 2006; 20 Suppl 17:97-110. DOI: 10.1111/j.1399-0012.2006.00608.x. View

Valente J, Hricik D, Weigel K, Seaman D, Knauss T, Siegel C . Comparison of sirolimus vs. mycophenolate mofetil on surgical complications and wound healing in adult kidney transplantation. Am J Transplant. 2003; 3(9):1128-34. DOI: 10.1034/j.1600-6143.2003.00185.x. View

10.

Gislason H, Soreide O, Viste A . Wound complications after major gastrointestinal operations. The surgeon as a risk factor. Dig Surg. 2000; 16(6):512-4. DOI: 10.1159/000018778. View

11.

Benavides C, Mahmoud K, Knight R, Barcenas C, Kahan B, Van Buren C . Rabbit antithymocyte globulin: a postoperative risk factor for sirolimus-treated renal transplant patients?. Transplant Proc. 2005; 37(2):822-6. DOI: 10.1016/j.transproceed.2004.12.121. View

12.

Roine E, Bjork I, Oyen O . Targeting risk factors for impaired wound healing and wound complications after kidney transplantation. Transplant Proc. 2010; 42(7):2542-6. DOI: 10.1016/j.transproceed.2010.05.162. View

13.

Laftavi M, Patel S, Soliman M, Alnimri M, Kohli R, Said M . Low-dose thymoglobulin use in elderly renal transplant recipients is safe and effective induction therapy. Transplant Proc. 2011; 43(2):466-8. DOI: 10.1016/j.transproceed.2011.01.039. View

14.

Merion R . 2008 SRTR Report on the State of Transplantation. Am J Transplant. 2009; 9(4 Pt 2):867-8. DOI: 10.1111/j.1600-6143.2009.02563.x. View

15.

Tiong H, Flechner S, Zhou L, Wee A, Mastroianni B, Savas K . A systematic approach to minimizing wound problems for de novo sirolimus-treated kidney transplant recipients. Transplantation. 2009; 87(2):296-302. DOI: 10.1097/TP.0b013e318192dd56. View

16.

Humar A, Key N, Ramcharan T, Payne W, Sutherland D, Matas A . Kidney retransplants after initial graft loss to vascular thrombosis. Clin Transplant. 2001; 15(1):6-10. DOI: 10.1034/j.1399-0012.2001.150102.x. View

17.

Humar A, Ramcharan T, Denny R, Gillingham K, Payne W, Matas A . Are wound complications after a kidney transplant more common with modern immunosuppression?. Transplantation. 2002; 72(12):1920-3. DOI: 10.1097/00007890-200112270-00009. View

18.

Lapsley H, Vogels R . Quality and cost impacts: prevention of post-operative clean wound infections. Int J Health Care Qual Assur Inc Leadersh Health Serv. 1999; 11(6-7):222-31. DOI: 10.1108/09526869810243935. View

19.

Rogers C, Hanaway M, Alloway R, Alexander J, Boardman R, Trofe J . Corticosteroid avoidance ameliorates lymphocele formation and wound healing complications associated with sirolimus therapy. Transplant Proc. 2005; 37(2):795-7. DOI: 10.1016/j.transproceed.2004.12.076. View

20.

Lopau K, Syamken K, Rubenwolf P, Riedmiller H, Wanner C . Impact of mycophenolate mofetil on wound complications and lymphoceles after kidney transplantation. Kidney Blood Press Res. 2010; 33(1):52-9. DOI: 10.1159/000289573. View