Infective Complications after Renal Transplantation – A Single Centre Experience Comparing Alemtuzumab to Basiliximab Induction
Renal Medicine, St James' University Hospital, Leeds, United Kingdom
Meeting: 2019 American Transplant Congress
Abstract number: A361
Keywords: Induction therapy, Infection, Kidney transplantation, Morbidity
Session Information
Session Name: Poster Session A: Transplant Infectious Diseases
Session Type: Poster Session
Date: Saturday, June 1, 2019
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall C & D
*Purpose: Our centre predominantly uses alemtuzumab as induction immunosuppression for renal transplantation. We examined infective complications after renal transplantation, comparing different induction, and maintenance, immunosuppression regimens.
*Methods: Retrospective analysis of all adult renal transplant patients followed up in our centre October 2013 to September 2016. Manual search of results systems for all microbiology results, with review of all admissions and documented infections, using electronic discharge summaries and clinic letters.
*Results: 252 patients received a renal transplant in the analysis period (44.6% DBD, 33.5% DCD, and 21.9% LRD). M:F ratio was 159:93 and the average age at time of transplantation was 49.4 years. 12.8% of patients had a 2DR mismatch. 74% of patients received alemtuzumab vs. 26% basiliximab. 83.7% were steroid free at discharge, with the majority of patients (54%) receiving tacrolimus monotherapy maintenance immunosuppression. A similar incidence of positive culture results was identified when comparing the two induction agents (see Figure 1). There was a higher incidence of wound (p=0.0086) and early post-operative (p=0.031) infections in the basiliximab group. Patients taking MMF following alemtuzumab induction had a higher incidence of UTI than those not taking MMF (p=0.044). 114 patients (45.6%) had admissions with infections over 227 admissions and 2527 hospital days (estimated cost £631,750). Median length of stay was 7 days (IQR 3.75-14). 33 transplants were lost in the follow up period, 12 relating to infection (6 deaths with a functioning transplant secondary to infection and 6 transplant failure due to infection).
*Conclusions: Findings suggest minimal difference in infective complication rates when comparing the two induction agents, with a higher incidence of early post-operative infections in the basiliximab group. Overall, infection rates appear to be comparable to other centres, with alemtuzumab induction not conferring a higher risk of viral infections, or infective complications overall.
To cite this abstract in AMA style:
Czajka R, Smith MWelberry, Gittus M, Lindley E, Vernon M. Infective Complications after Renal Transplantation – A Single Centre Experience Comparing Alemtuzumab to Basiliximab Induction [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/infective-complications-after-renal-transplantation-a-single-centre-experience-comparing-alemtuzumab-to-basiliximab-induction/. Accessed May 18, 2025.« Back to 2019 American Transplant Congress