Drugs may be given during the peri-transplant (before and after infusion) period to prevent transplant-related complications or facilitate engraftment.
Question 86: ALG, ALS, ATG, ATS
Anti-Lymphocyte Globulin (ALT), Anti-Lymphocyte Serum (ALS), Anti-Thymocyte Globulin (ATG), or Anti-Thymocyte Serum (ATS) are serum or gamma globulin preparations containing polyclonal immunoglobulins directed against lymphocytes. These drugs are usually prepared from animals immunized again human lymphocytes.
Indicate if ALG, ALS, ATG, or ATS was administered during the peri-transplant period.
Question 87: Total dose
Report the total dose actually given during the peri-transplant period (before and after infusion). Do not report the prescribed dose or the daily dose. The pharmacy record or Medication Administration Record (MAR) should be used for determining the exact total dose given.
Questions 88 – 89: Absolute lymphocyte count (prior to first dose)
Indicate if the absolute lymphocyte count is Known prior to the first administration dose of ALG, ALS, ATG, or ATS. If Known, report the absolute lymphocyte count and specify the units of measurement.
Questions 90 – 91: Date first dose
Indicate if the date when the first dose of ALG, ALS, ATS, or ATS was administered is Known. If Known, report the date when the first dose was administered.
If the exact date is not known, use the process described in General Instructions, Guidelines for Completing Forms.
Questions 92 – 93: Date last dose
Indicate if the date when the last dose of ALG, ALS, ATS, or ATS was administered is Known. If Known, report the date when the last dose was administered.
If the exact date is not known, use the process described in General Instructions, Guidelines for Completing Forms.
Question 94: Alemtuzumab (Campath)
Antibody preparations that are infused in the recipient. Indicate if alemtuzumab was administered during the peri-transplant period.
Question 95: Total dose
Report the total dose actually given during the peri-transplant period (before and after infusion). Do not report the prescribed dose or the daily dose. The pharmacy record or Medication Administration Record (MAR) should be used for determining the exact total dose given.
Questions 96 – 97: Date first dose
Indicate if the date when the first dose of alemtuzumab administered is Known. If Known, report the date when the first dose was administered.
If the exact date is not known, use the process described in General Instructions, Guidelines for Completing Forms.
Questions 98 – 99: Date last dose
Indicate if the date when the last dose of alemtuzumab was administered is Known. If Known, report the date when the last dose was administered.
If the exact date is not known, use the process described in General Instructions, Guidelines for Completing Forms.
Question 100: Were clinically significant donor specific anti-HLA antibodies detected?
Indicate if clinically significant donor specific anti-HLA antibodies were detected.
If testing for clinically significant donor specific anti-HLA antibodies was not performed, select Not done.
Questions 101 – 103: Was the recipient on a desensitization protocol?
Indicate if the recipient was on a desensitization protocol. If Yes, check the method(s) of desensitization. If Other method is selected, specify.
Section Updates:
| Question Number | Date of Change | Add/Remove/Modify | Description | Reasoning (If applicable) |
|---|---|---|---|---|
| . | . | . | . | . |
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