During a two-year period, nine patients received equine antilymphocyte globulin (ALG) as part of their immunosuppressive therapy following cadaver renal transplantation. Of these, three patients (33%) developed nephrotic syndrome. A fourth patient had proteinuria greater than 3 gm/24 hr not attributable to recurrent disease or rejection. Of 32 other patients with cadaver renal allografts done during the same time, none had nephrotic syndrome and two (6%) had proteinuria greater than 3 gm/24 hr, both with biopsy evidence of rejection. This suggests an association between ALG therapy and risk for developing nephrotic syndrome, but the mechanism is not clear and deserves further investigation. During the first three months following transplantation, the nine patients treated with ALG had 20 infections, which seems to be more per patient than in our other transplant recipients.
Michel RP, Guttmann RD, Knaack J, Klassen J, Beaudoin J, Morehouse DD. Antilymphocyte Globulin in Renal TransplantationNephrotic Syndrome and Infection as Possible Complications. Arch Surg. 1975;110(1):90-93. doi:10.1001/archsurg.1975.01360070090016