Safety and Feasibility of Outpatient Rabbit Antithymocyte Globulin Induction Therapy Administration in Kidney Transplant Recipients
Autor: | Jennifer Trofe-Clark, Simin Goral, Roy D. Bloom, Deirdre Sawinski, Susanna M. Nazarian, Matthew H. Levine, Paige M. Porrett, Mary Ann Lim, Ali Naji, Peter L. Abt, Melissa Bleicher, David Johnson, Alexandra N. Varga |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Peripheral intravenous 030230 surgery Kidney transplant Patient Readmission 03 medical and health sciences 0302 clinical medicine Induction therapy Outpatients Medicine Animals Pharmacology (medical) Antilymphocyte Serum Retrospective Studies business.industry Retrospective cohort study After discharge Length of Stay medicine.disease Kidney Transplantation Naranjo Adverse Drug Reaction Probability Scale Rabbit antithymocyte globulin Emergency medicine Feasibility Studies 030211 gastroenterology & hepatology Rabbits business Adverse drug reaction Immunosuppressive Agents |
Zdroj: | Pharmacotherapy. 38(6) |
ISSN: | 1875-9114 |
Popis: | Background Kidney transplant induction therapy often includes inpatient administration of rabbit antithymocyte globulin (rATG) over multiple days. To reduce hospital length of stay (LOS) and drug expenditures, the rATG induction course was completed in the outpatient setting via peripheral intravenous administration. The present study assesses early readmission trends ascribable to an outpatient rATG administration protocol to ensure initial reduction in hospital LOS is sustained early after discharge. Methods This was a retrospective study of kidney recipient outcomes for patients transplanted between January 1, 2008, and February 29, 2016, immediately following implementation of an outpatient rATG protocol. Readmission data within 7 days of outpatient rATG administration were collected. The relatedness of rATG administration to an adverse drug reaction resulting in readmission was determined by the World Health Organization-Uppsala Monitoring Centre Causality Assessment Scale and the Naranjo Adverse Drug Reaction Probability Scale. Results A total of 1104 patients received outpatient doses of rATG and were included. An upward trend in kidney transplant volume and outpatient rATG administrations per year was found from 2008-2015. Following protocol implementation, the percentage of overall readmissions ranged from 9% to just over 12% from 2008-2014 and remained less than 10% for 2014 through 2016. The percentage of outpatient rATG infusions that potentially led to rATG-related readmissions was less than 4% per year over the study period. A total of 1124 hospital days were saved, 125 days per year on average. Conclusions Outpatient administration of rATG is feasible, safe, and did not increase readmissions in the period directly following administration. The findings of this analysis support our continued use of the outpatient rATG protocol at our institution. |
Databáze: | OpenAIRE |
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