Publications [#355230] of Chi Wei C. Chan

Papers Published

1. Shaw, BI; Lee, H-J; Chan, C; Ettenger, R; Grimm, P; Pearl, M; Reed, EF; Robien, MA; Sarwal, M; Stempora, L; Warshaw, B; Zhao, C; Martinez, OM; Kirk, AD; Chambers, ET, Relationship between antithymocyte globulin, T cell phenotypes, and clinical outcomes in pediatric kidney transplantation., Am J Transplant, vol. 21 no. 2 (February, 2021), pp. 766-775 [doi]
   (last updated on 2026/01/15)

   Abstract:
   Depletional induction using antithymocyte globulin (ATG) reduces rates of acute rejection in adult kidney transplant recipients, yet little is known about its effects in children. Using a longitudinal cohort of 103 patients in the Immune Development in Pediatric Transplant (IMPACT) study, we compared T cell phenotypes after ATG or non-ATG induction. We examined the effects of ATG on the early clinical outcomes of alloimmune events (development of de novo donor specific antibody and/or biopsy proven rejection) and infection events (viremia/viral infections). Long-term patient and graft outcomes were examined using the Scientific Registry of Transplant Recipients. After ATG induction, although absolute counts of CD4 and CD8 T cells were lower, patients had higher percentages of CD4 and CD8 memory T cells with a concomitant decrease in frequency of naïve T cells compared to non-ATG induction. In adjusted and unadjusted models, ATG induction was associated with increased early event-free survival, with no difference in long-term patient or allograft survival. Decreased CD4+ naïve and increased CD4+ effector memory T cell frequencies were associated with improved clinical outcomes. Though immunologic parameters are drastically altered with ATG induction, long-term clinical benefits remain unclear in pediatric patients.