Toledo‐Pereyra 1985.

Methods	Study design: parallel RCT Study duration: not reported Study follow‐up: 1 year
Participants	Country: USA Setting: single centre Inclusion criteria: 1st DD kidney transplant recipients Number: treatment group 1 (25); treatment group 2 (25) Mean age (years): treatment group 1 (47); treatment group 2 (42) Sex (M/F): treatment group 1 (18/7); treatment group 2 (16/9) Black/white: treatment group 1 (11/14); treatment group 2 (5/20) Exclusion criteria: not reported
Interventions	Treatment group 1 Horse or goat ALG: 20 mg/kg/d, starting 1 day post‐op, for 14 days; adjust as per WCC and platelets (dose 5 to 20 mg/kg/d) Dose adjusted if platelets fell to 50 to 100 x 103/mm3, or WCC 3000 to 5000/mm3 Stopped if platelets < 50,000/mm3 or WCC < 3000/mm3 Treatment group 2 hATG: up to 15 mg/kg/d, started 1 day post‐op, continued for 14 days at dose 5 to 15 mg/kg/d Dose adjusted if platelets fell to 50 to 100 x 103/mm3, or WCC 3000 to 5000/mm3 Stopped if platelets < 50,000/mm3 or WCC < 3000/mm3 Immunosuppression (both groups) AZA 5mg/kg/d on 1st day post‐op, then 1 to 2.5 mg/kg/d as per WCC PRED: 1 mg/kg/d, reduced to 20 to 25 mg/d by 3rd or 4th week
Outcomes	Death Graft loss Acute rejection Side effects
Notes	Funding source: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient information to permit judgement
Allocation concealment (selection bias)	Unclear risk	Insufficient information to permit judgement
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Unlikely to influence outcomes
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Unlikely to influence outcomes
Incomplete outcome data (attrition bias) All outcomes	Low risk	All patient outcome data reported
Selective reporting (reporting bias)	Low risk	All expected outcomes reported
Other bias	Unclear risk	Funding source not reported