Language
English
Publication Date
1-1-2025
Journal
Frontiers in Transplantation
DOI
10.3389/frtra.2025.1607678
PMID
40687845
PMCID
PMC12271178
PubMedCentral® Posted Date
7-4-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Introduction: Lung transplantation has seen strides in survival over the past few decades, though long-term survival remains poor. Chronic lung allograft dysfunction (CLAD) is a leading cause of graft failure and mortality beyond the first year. Anti-thymocyte globulin (ATG) is commonly used for treating refractory CLAD, though its efficacy remains uncertain.
Methods: This retrospective study evaluated the impact of ATG on lung function decline and mortality among lung transplant recipients diagnosed with CLAD, defined as a persistent >20% decline in forced expiratory volume (FEV1) from baseline. Patients treated with ATG were compared to those who did not receive ATG, using mixed effects modeling for FEV1 decline and Fine-Gray competing risk modeling for mortality.
Results: Of the 124 patients with CLAD, 55 (44%) received ATG. Administration was not associated with a significant change in FEV1 decline when compared to rate of decline prior to ATG administration [-0.0881 L/year, 95% CI (-0.21, 0.034)] or compared to non-ATG recipients [0.0599 L/year, 95% CI (-0.057, 0.18)]. However, ATG was associated with a lower hazard of all-cause mortality [subhazard ratio 0.66, 95% CI (0.39-1.14)].
Discussion: While ATG improved survival, it did not alter lung function decline, affirming the need for prospective randomized studies.
Keywords
chronic lung allograft dysfunction, anti-thymocyte globulin, lung function, FEV1, CLAD, ATG
Published Open-Access
yes
Recommended Citation
Padhye, Akhilesh Ajay; Guffey, Danielle; Leon-Pena, Andres; et al., "Antithymocyte Globulin Therapy in Chronic Lung Allograft Dysfunction" (2025). Faculty and Staff Publications. 4184.
https://digitalcommons.library.tmc.edu/baylor_docs/4184