HAS ANTI-LYMPHOCYTE THERAPY BECOME OBSOLETE FOR PEDIATRIC LIVING-DONOR KIDNEY TRANSPLANTS?
To determine whether the removal of prophylactic antilymphocyte therapy (ALT) from our immunosuppression protocol significantly increased the incidence of early acute rejection or decreased short-term graft function, we retrospectively reviewed the charts of all patients less than 19 years of age who received living-related, primary renal transplants at our center between 1991 and 1995. Patients who received donor-specific transfusions were excluded. 13 patients transplanted prior to January, 1995 received a minimum of 7 days of ALT (ATG or MALG) beginning at the time of transplant (group 1), whereas none of the 17 patients transplanted after January, 1995 received such therapy (group 2). Patients in both groups received methylprednisolone, azathioprine and cyclosporine in the post-operative period. The incidence of a first rejection episode in the 3 months following transplantation was 4/13 (31 %) in group 1 and 2/17 (12 %) in group 2. First rejection episodes occurred an average of 3
