Thymoglobulin

Premedicate with corticosteroids, acetaminophen, and/or antihistamines 1 hour prior to each infusion. Give by IV infusion over 6 hours for first infusion into a high-flow vein, and over 4 hours on subsequent days of therapy. Prophylaxis: 1.5mg/kg once daily for 4–7 days; give first dose before reperfusion of the donor kidney. Treatment: 1.5mg/kg once daily for 7–14 days. WBC count 2000–3000 cells/mm³ or platelet count 50000–75000 cells/mm³: reduce dose by ½. WBC <2000 cells/mm³ or platelets <50000 cells/mm³: consider discontinuing therapy. When concomitant immunosuppressants: administer antifungal and antibacterial prophylaxis if clinically indicated. CMV-seropositive at the time of transplant or CMV-seronegative recipient from a CMV-seropositive donor: give antiviral prophylaxis. Consider decreasing maintenance immunosuppression therapy during Thymoglobulin use to avoid over-immunosuppression.