*Purpose: Alemtuzumab induction in septuagenarians is controversial but understudied.

*Methods: Single center retrospective review of adult deceased donor kidney transplant (KT) recipients receiving single dose (30 mg) alemtuzumab induction stratified by age (30-49, 50-69, ≥70 years). All patients received FK/MPA/± steroids with those ≥60 years receiving half dose MPA.

*Results: From Jan 2006 to Aug 2018, we performed 1386 KTs with alemtuzumab induction in patients ≥ age 30 (421 age 30-49, 761 age 50-69, 204 age ≥70 years). Mean donor age (34±17, 47±17, 54±15 years), extended criteria donor (ECD) kidney use (11, 38, 58%), kidney donor profile index (47±24, 64±25, 74±22%) and dual KTs (1, 5, 9%) all increased with older age group (p<0.05). Cold ischemia time (25±8, 26±8, 26±7 hrs) and donation after cardio-circulatory death use did not differ between groups. Mean recipient age (41±6, 60±6, 74±3 years) and time on waitlist (28±25, 20±19, 14±15 months) differed (p<0.05) while BMI was comparable between groups. With mean follow-up of 4.4 years, overall graft survival (70, 62, 57%) and patient survival (87, 74, 66%) rates decreased with older age group (p<0.05), while death censored graft survival rates (77, 75, 76%) were comparable. Rates of delayed graft function (33, 35, 28%) and serum creatinine at 1 year post transplant (1.60±0.7, 1.62±0.6, 1.53±0.7) did not vary between groups (NS). Overall rates of acute rejection and major infection within the first year were 25%, and 15%, respectively, with no significant differences identified between groups.

*Conclusions: Alemtuzumab induction appears to be safe and effective regardless of recipient age. Use of alemtuzumab in elderly recipients may mitigate any potential negative immunologic effects of receiving ECD kidneys.

« Back to 2019 American Transplant Congress