Thymoglobulin and rate of infectious complications after transplantation

Thymoglobulin is used as an induction agent in kidney transplantation, but the optimal dose is not well established. However, its use may be associated with increased infectious complications after transplantation.Methods. This retrospective study of 61 high-risk renal recipients of transplants from deceased donors performed between June 2001 and April 2004 included patients treated with thymoglobulin. Patients were divided into two groups according to the total thymoglobulin dose (G1, n = 30, 7 mg/kg) and followed for at least 1 year.Results. Mean recipient age was 43 14 years; 41% were males; 63% non-Whites. Mean cold ischemia time was 26.3 +/- 7 hours. Mean PRA was 23% (0-100%). Second transplantation was performed in 18 (29.5%) patients. Mean donor age was 42.1 +/- 16 years, and 59% had a cerebral vascular accident as the cause of death. Patient- and death-censored graft survival at 12 months were 86% and 88%, respectively. There were 149 infectious episodes among 47 (78%) patients. the incidence of infection was 1.7 +/- 0.24 infections per patient per year in G1 (lower dose) vs 3.12 +/- 0.23 in G2 (P < .001). Bacterial (0.66 +/- 1.0 vs 1.48 +/- 1.26 infections per patient per year, P =.009) and viral infections (0.9 +/- 0.71 vs 1.41 +/- 0.71; P =.006) were more frequent in the higher dose group.Conclusion. This study suggested that a greater number of infectious episodes were present when the total dose of thymoglobulin was higher than 7 mg/kg.Universidade Federal de São Paulo, Hosp Rim & Hipertensao, Div Nephrol, São Paulo, BrazilUniversidade Federal de São Paulo, Hosp Rim & Hipertensao, Div Nephrol, São Paulo, BrazilWeb of Scienc

Repeaterless Transmission With 62.9 dB Power Budget Using A Highly Efficient Erbium-Doped Fiber Amplifier Module

Laser-diode-pumped erbium-doped fiber amplifiers (EDFA) have recently demonstrated all their potential for very long haul transmissions [1]. In-line EDFA application is clearly identified for long undersea links. However, repeaterless transmissions have many applications, especially over 250 km lengths. Compared to direct detection, heterodyne detection allows to achieve a very high receiver sensitivity, increasing the overall link budget [2], Optical amplifiers highly improve this budget, particularly by compensating for the insertion loss of the external phase modulator in DPSK systems. We report a 565 Mbit/s DPSK transmission experiment at 1.532 μm using an EDFA module at the emission, operating in gain saturation regime. Pumped by laser diodes, this optical post-amplifier delivers an amplified output power exceeding +13 dBm, leading to a repeaterless power budget of 62.9 dB. This gives the potentiality to design over 350 km repeaterless links by use of a pure silica core fiber.</jats:p