Introduction: “Non-adherent” (NA) is defined as chronic follow-up absenteeism or medication nonadherence. We aimed to determine whether the single-dosing schedule of Alemtuzumab (Ale) may limit associated long-term sequalae.

Methods: A retrospective analysis was performed on 675 renal transplants with Ale induction and relative steroid freedom, transplanted at the University of Toledo Medical Center between 03/06 and 05/15.

Results: 82 patients were identified as NA on review. NA patients were statistically significantly younger (median age 35.5±14 years vs. 56.6±12.9, p<0.001), more likely to be African-American (31.7% vs. 21.2%, p=0.047), and less likely to have private health insurance (35.8% vs. 48.6%, p=0.033). They were also likely to have superior donors (median donor age 33±14.7 years vs. 40±14.7, p=0.008; median KDPI 29±22.8 vs. 39±26.5, p=0.024). Non-significant factors are displayed in Table 1.

Transplantation outcomes were statistically equivalent at 1 and 3 years for rejection (24.9% vs 21.1% and 32.6% vs. 25.6%), graft survival (93.8% vs. 95.2% and 82.5% vs. 90.3%) and patient survival (97.5% vs. 95.9% and 96% vs. 89.1%). At 5 years, NA patients had better patient survival (93.9% vs. 83.6%, p=0.047), and had non-significantly worse rejection (41.3% vs. 27.7%, p=0.07) and graft survival (76% vs. 86.1%, p=0.054). A matched pair subset of the control group eliminated the demographic significant differences, resulting in a resolution of all outcome differences.

Conclusion: With Ale induction therapy and controlling for demographic differences, NA renal transplant recipients appear to do no worse than adherent ones. In centers with younger/more African-American populations (deomgraphically NA), Ale induction may be an attractive choice.

CITATION INFORMATION: Mitro G., Ekwenna O., Rees M., Ortiz J. Alemtuzumab Induction as a Mediator of Nonadherence in Renal Transplantation Am J Transplant. 2017;17 (suppl 3).

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