*Purpose: Minimal literature exists regarding alemtuzumab for induction in lung transplantation but is the preferred agent at Temple University Hospital (TUH). Basiliximab is reserved for patients with higher risk of infection and/or malignancy. At TUH, high risk is defined by high risk CMV and EBV status (D+/R-), history of hepatitis B/C virus infection, history of HIV, and history of malignancy. Alemtuzumab may pose a higher risk of adverse events, but literature has shown conflicting results. The purpose of this study is to identify the differences in patient outcomes between alemtuzumab and basiliximab.

*Methods: One-hundred twelve patients received a lung transplant between August 2016 to September 2017 (56 in each group). The primary outcome is the percentage of antibiotic-free days within 12 months. Secondary outcomes include rates of acute rejection, viral and fungal infections, leukopenia, neutropenia, readmissions, and graft and patient survival within 12 months.

*Results: There was no statistically significant difference in percentage of antibiotic-free days between the two groups (96.4% vs. 96.1%; p=0.96). No statistically significant differences were seen in all secondary outcomes, with the exception of a higher incidence of CMV viremia in the basiliximab group. Graft and patient survival were similar between both groups. Additional information is in Table 1 and Table 2.

*Conclusions: Our findings suggest that patient outcomes between alemtuzumab and basiliximab were similar within 12 months of lung transplant. A higher incidence of CMV viremia in the basiliximab group can be attributed to an increased number of high CMV risk patients in this group. The results from this study suggest that a risk-stratified approach in selecting induction in lung transplant recipients based on infection risk provides reasonable clinical outcomes. Larger studies are required to evaluate the risks and benefits of induction selection in this population.

« Back to 2019 American Transplant Congress