BCTXP Board Certified Solid Organ Transplantation Pharmacist

BCTXP Board Certified Solid Or…

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1. A 45-year-old male with a history of sensitized ESRD (cPRA 85%) undergoes a deceased donor kidney transplant. The surgical team decides to use rabbit anti-thymocyte globulin (rATG) for induction therapy at a total dose of 6 mg/kg. On post-operative day 3, the patient's absolute neutrophil count (ANC) drops to 800 cells/mm³ and his platelet count is 45,000 cells/mm³. Which of the following is the most appropriate management strategy for his remaining rATG doses?

Continue the current rATG dose but administer it over 12 hours instead of 6 hours.Reduce the rATG dose by 50% and monitor CBC daily.Discontinue rATG immediately and switch to basiliximab induction.Administer filgrastim 5 mcg/kg and continue the full rATG dose.

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