Administration of rabbit antithymocyte globulin (thymoglobulin) in ambulatory renal-transplant patients

Background. Antilymphocyte globulins have been used for the treatment and prevention of acute rejection in renal-allograft recipients. Thymoglobulin, rabbit antithymocyte globulin (RATG), has been shown to be effective for these indications and has been used primarily on an inpatient basis because of the recommendation that it be administered through a central line. Methods. We retrospectively reviewed the charts of all patients treated with RATG since its first use in 1999. After premedication, the dose of RATG was administered over 4 to 6 hours, with 1,000 units of heparin and 20 mg of hydrocortisone to reduce the incidence of thrombosis and. local tissue reaction. All adverse reactions were recorded. Results. Eighteen patients underwent a total of 57 outpatient infusions. Of the 57 infusions, 52 (91%) were without complication. Five infusions (9%) were complicated by infiltrates. No serious reactions were noted. Conclusions. These data confirm that peripheral, outpatient administration of RATG is safe.