Thymoglobulin
Thymoglobulin is an intravenous (IV) medication that you might receive once you get a kidney transplant. It belongs to the drug class called depleting polyclonal antibodies. This medication lowers the activity of your immune system to prevent it from rejecting your new organ. It's typically used in addition to other immunosuppressants. Thymoglobulin can cause many infusion reactions and side effects like fever, chills, headache, low blood cell count, and high potassium levels. Because it weakens your immune system, the medication puts you at high risk for developing infections.
What is Thymoglobulin?
What is Thymoglobulin used for?
- To prevent rejection in people who've just had a kidney transplant
- To treat rejection in people who've had a kidney transplant
How Thymoglobulin works
Thymoglobulin is a type of protein called a depleting polyclonal antibody. It works by depleting (or wiping out) the white blood cells (T cells and B cells) that would otherwise work to reject your transplanted organ. This is thought to help prevent and treat organ rejection.
Drug facts
Common questions about Thymoglobulin
Your transplant team will run the infusion over at least 6 hours for your first dose of Thymoglobulin. Running the infusion at a slow rate helps lower the chances of side effects or an infusion reaction, such as fever, chills, trouble breathing, nausea, and headache. If you tolerate the first dose well, your next Thymoglobulin infusions can run over a shorter period of time (over at least 4 hours). In addition to the Thymoglobulin infusion itself, your transplant team will give you "premedications" 1 hour before each infusion to help lower your risk for reactions; these medications can include acetaminophen (Tylenol), an antihistamine, and steroids.
No, Thymoglobulin is typically only given in a hospital or healthcare setting under the supervision of a trained healthcare professional. This infusion takes several hours and you'll need to be monitored for any infusion reactions during this time.
Your Thymoglobulin dose will depend on your weight (1.5 mg/kg per day). Your transplant specialist will spread your treatment over a span of several days (4 to 7 days to prevent rejection; 7 to 14 days to treat rejection). The team might lower your dose or stop your Thymoglobulin treatment altogether if they see that your blood cells or platelets drop too much.
No. Thymoglobulin is approved for use in combination with other forms of immunosuppression to help prevent and treat organ rejection. Different anti-rejection medications have different ways of lowering the activity of your immune system. And using multiple ways of doing so can help lessen the chances that your immune system becomes too active and rejects your new kidney.
Some people might have a reaction where the needle goes into the skin, such as discomfort, skin redness, and swelling. Some people might also have reactions to the Thymoglobulin infusion itself, including fever, chills, trouble breathing, nausea, vomiting, and headache. These infusion-related reactions can be a sign that the Thymoglobulin infusion is working but is given too fast; your care team can slow down the infusion to help with this. In addition, Thymoglobulin can cause your blood cell counts to drop to dangerous levels since it works by wiping out these cells in your body. Your transplant team will monitor your side effects and blood work throughout your entire Thymoglobulin treatment course.
The effects of Thymoglobulin can last for several months after you finish your treatment. Once the medication wipes out your cell counts, it takes a while for your body to make new cells and for your cell counts to recover. In a clinical study, about 40% of participants treated with Thymoglobulin had a 50% "rebound" or recovery of their white blood cells 3 months after their last dose. Your risk of rejection is highest during the first 3 months after transplant, so the prolonged effects of Thymoglobulin will help keep your newly-transplanted kidney protected from your immune system.
After your treatment with Thymoglobulin, your transplant team might prescribe anti-infectives for you to take by mouth for a few months to prevent infections. It's just as important to take these medications along with your immunosuppressants because you'll essentially have very little protection against bacteria, viruses, and fungi that are in the environment. Other ways to lower your risk for getting sick after transplant include staying up to date with vaccinations that are recommended by your transplant team, washing your hands often, and avoiding any interactions with sick people. Tell your transplant team right away if you start to have cold or flu symptoms (e.g., fever, cough, sore throat) because an infection can become very serious if it's left untreated.
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Thymoglobulin dosage
Typical dosage for Thymoglobulin
