REVIEW ARTICLE New Directions for Rabbit Antithymocyte Globulin (Thymoglobulin) in Solid Organ Transplants, Stem Cell Transplants and Autoimmunity

The Author(s) 2014. This article is published with open access at Springerlink.com Abstract In the 30 years since the rabbit antithymocyte globulin (rATG) Thymoglobulinwas first licensed, its use in solid organ transplantation and hematology has expanded progressively. Although the evidence base is incomplete, specific roles for rATG in organ transplant recipients using contemporary dosing strategies are now relatively well-iden-tified. The addition of rATG induction to a standard triple or dual regimen reduces acute cellular rejection, and possibly humoral rejection. It is an appropriate first choice in patients with moderate or high immunological risk, and may be used in low-risk patients receiving a calcineurin inhibitor (CNI)-sparing regimen from time of transplant, or if early steroid withdrawal is planned. Kidney transplant patients at risk of delayed graft function may also benefit from the useof rATG t