Antithymocyte immune globulin,

Antithymocyte globulin (Atgam) is purified immune globulin obtained from hyperimmune serum of horses... 

Antithymocyte Globulin (See Lymphocyte Immune Globulin) [Immunosuppressive Agent]... 

Induction therapy with polyclonal and monoclonal antibodies (mAbs) has been an important component of inunu-nosupression when the beneficial effect of antilymphocyte globulin (ALG) in the prophylaxis of rejection in renal transplant recipients was demonstrated. Over the past 40 years, several polycolonal antilymphocyte preparations have been used in renal transplantation however, only two preparations are currently FDA approved lymphocyte immune globulin (ATGAM) and antithymocyte globulin (Thymoglobulin). 

LYMPHOCYTE IMMUNE GLOBULIN (Antithymocyte globulin [equine]) (Atgam)... 

Indicated and approved for the management of allograft rejection in renal transplant patients, antithymocyte globulin preparations are purified immune globulins (primarily IgG) from horses or rabbits immunized with human thymus lymphocytes. The resultant globulin preparations contain cytotoxic antibodies to human T lymphocytes which function as an immunosuppressive agent. As well as its use for the treatment of renal transplant rejection, anti-thymocyte globulin may be administered as an adjunct to other immunosuppressive... 

Antisera directed against lymphocytes have been prepared sporadically for over 100 years. With the advent of human organ transplantation as a therapeutic option, heterologous antilymphocyte globulin (ALG) took on new importance. ALG and antithymocyte globulin (ATG) are now in clinical use in many medical centers, especially in transplantation programs. The antiserum is usually obtained by immunization of large animals such as horses or sheep with human lymphoid cells. 

ANTITHYMOCYTE GLOBULIN Antithymocyte globulin is a purified gamma globulin from the serum of rabbits immunized with human thymocytes. 

Serious immune-mediated reactions to antithymocyte globulin include anaphylaxis, severe cytokine release syndrome, and severe acute infusion-associated reactions. Serum sickness with fever, rash, arthralgia, and myalgia may appear 5-15 days after the initiation of therapy. Cutaneous reactions seen include urticaria, morbilliform eruptions, and acral erythematous eruptions preceding rash. 

Many different types of immunosuppressants can be used to prevent or control rejection. Most of them, including steroids, suppress the entire immune system (Merck 2003). Antilymphocyte globulin, antithymocyte globulin, and monoclonal antibodies suppress only specific parts of the immune system. Immunosuppressants must be taken for an indefinite period. High doses are usually necessary for the first few weeks, and after that smaller doses can usually prevent rejection (Stark et al. 2002 Villard 2006). 

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