Cumulative weight–based rabbit antithymocyte globulin dosing for induction in heart transplantation: Impact on outcomes
Bibliographic record
Abstract
Background Optimal dose of rabbit anti-thymocyte globulin (rATG) for heart transplantation (HTx) induction remains uncertain. We conducted a retrospective analysis to assess the effect of cumulative rATG weight-based dosing in HTx induction. Methods We retrospectively analyzed a total of 340 primary HTx patients (1983-2018) receiving a fixed rATG dose (125 mg daily for 3 days). Patients were retrospectively categorized based on cumulative rATG exposition: Group A (<4.5 mg/kg), Group B (4.5 to 7.5 mg/kg), and Group C (>7.5 mg/kg). The primary composite outcome (death, acute rejection, and infection) and its components were evaluated at 24 months using absolute incidence, Kaplan-Meier survival curves, and Cox modeling. Results Group A had a non-significant lower incidence of the primary composite endpoint (A: 76.8%, B: 83.7%, C: 96.2%; p=0.075), primarily driven by lower infections, with group B having significantly better survival for the primary composite endpoint than group C on Kaplan-Meier curves (B vs. C log-rank p=0.044). Group B had lower mortality than group C (p=0.012). Lower incidence of infection in Group A compared to Group B (p=0.035) was also noted. No significant difference was observed in acute rejection episodes. Conclusions At 24 months post-HTx, our findings suggest that a cumulative rATG-dosing of 4.5-7.5 mg/kg offers the best balance of AR, mortality, and infection, mainly by reducing risk of infections and to a lesser degree mortality, without increasing AR. A cumulative dose <4.5 mg/kg offers the lowest risk of infection, with 4.5 mg/kg likely representing the intersection dose.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".