rabbit anti-human thymocyte immunoglobulin at a glance
Medicine class
Polyclonal antibody immunosuppressant that mainly depletes T lymphocytes.
Licensed roles
Preventing kidney or heart graft rejection and treating corticosteroid-resistant kidney graft rejection.
Administration
A slow intravenous infusion given by trained hospital staff, with close observation during and afterwards.
Important risks
Infusion reactions, infection and reduced white-cell or platelet counts require active monitoring.
What is rabbit anti-human thymocyte immunoglobulin used for?
The selected product is licensed for immunosuppression in solid-organ transplantation.
Preventing graft rejection after kidney transplantation.
Treating kidney-transplant rejection that is resistant to corticosteroids.
Preventing graft rejection after heart transplantation.
Non-licensed context: rabbit anti-thymocyte globulin is also used in specialist allogeneic stem-cell transplantation protocols to reduce graft-versus-host disease or graft rejection; this is outside this product's licence.
How does rabbit anti-human thymocyte immunoglobulin work?
The rabbit-derived antibodies bind to several targets on immune cells, particularly T lymphocytes. They remove or deactivate these cells through mechanisms including apoptosis, complement-mediated lysis and antibody-dependent cytotoxicity, while also affecting B cells, dendritic cells and cell-adhesion pathways involved in graft rejection.
rabbit anti-human thymocyte immunoglobulin preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 25 mg
How to take rabbit anti-human thymocyte immunoglobulin
This treatment is not taken by mouth or self-administered. Hospital staff reconstitute and dilute the powder, then give it slowly into a vein through an in-line filter. Corticosteroids and antihistamines are normally given beforehand, and an antipyretic may also be used to reduce infusion reactions. Food and drink are unlikely to affect treatment.
Tell staff about rabbit or animal allergies, current infections, vaccinations and all other treatments before the infusion.
Staff monitor breathing, pulse, blood pressure, skin reactions and blood counts during treatment.
Do not drive or operate machinery while being treated because infusion reactions can impair your ability to do so.
rabbit anti-human thymocyte immunoglobulin side effects
Common or expected effects
- Fever, shivering or headache, particularly around an infusion
- Low lymphocyte, neutrophil, platelet or red-cell counts
- Infection or reactivation of an existing infection
- Nausea, vomiting, diarrhoea or difficulty swallowing
- Rash, itching, muscle pain or shortness of breath
- Low blood pressure or raised liver enzymes
Get urgent medical advice
- Anaphylaxis: breathing difficulty, facial or throat swelling, widespread itchy rash or collapse
- Severe cytokine-release syndrome, which may cause marked breathing or cardiovascular problems
- Serious infection or sepsis, including fever, chills, sore throat or mouth ulcers
- Marked bleeding or bruising associated with low platelets
- Liver injury, such as jaundice or severe unexplained abdominal symptoms
- Serum sickness, often appearing later with fever, rash, hives and joint or muscle pain
rabbit anti-human thymocyte immunoglobulin in pregnancy
Pregnancy safety data are limited, and potential fetal harm is unknown. Treatment should be used during pregnancy only when clearly needed following specialist assessment. Tell the transplant team immediately if you are pregnant, may be pregnant or are planning pregnancy.
rabbit anti-human thymocyte immunoglobulin while breastfeeding
It is unknown whether this treatment enters human milk, although other immunoglobulins do. Product information advises stopping breastfeeding during treatment; discuss feeding options with the specialist team.
rabbit anti-human thymocyte immunoglobulin interactions
Formal interaction studies have not been performed, but clinically important additive and practical interactions are recognised.
Other immunosuppressants
Combining treatments increases overall immunosuppression and may raise the risks of severe infection and malignancy, so coordinated monitoring is required.
Live attenuated vaccines
Live vaccination is not recommended soon after treatment because safety is unestablished; other vaccines may also produce a weaker response.
Heparin and hydrocortisone in dextrose infusion
This combination can precipitate when mixed with the product and should not be used in the same dextrose infusion.
Common questions about rabbit anti-human thymocyte immunoglobulin
Answers are fully visible for fast scanning and source review.
Is rabbit anti-human thymocyte immunoglobulin chemotherapy?
No. It is a biological polyclonal antibody treatment that suppresses the immune system, mainly by depleting T lymphocytes.
Why is rabbit anti-human thymocyte immunoglobulin made using rabbits?
Rabbits are immunised with human thymus cells so they produce antibodies against human immune-cell targets; these antibodies are then purified for treatment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.