*Purpose: To identify the short-term efficacy and safety outcomes of alemtuzumab (C1H) versus rabbit antithymocyte globulin (rATG) in lung transplant patients. The objectives are to compare primary graft dysfunction (PGD), time to extubation, and time to hemodynamic stability between the two induction agents.

*Methods: This was a retrospective study conducted at Mayo Clinic. Adult patients who received their initial lung transplant with C1H or rATG at Mayo Clinic from October 2018 to June 2019 were included. Patients were excluded if they received a multi-organ transplant, had a prior transplant, received agents other than study drugs for induction, did not receive a calcineurin inhibitor for maintenance immunosuppression, did not receive anti-infective prophylaxis, or died within 1 month post-transplant. Fisher’s exact test was performed for nominal variables and Mann-Whitney U was used for continuous variables. Statistical significance was achieved when p < 0.05.

*Results: Patients who received C1H for induction had lower incidences of PGD from 0 to 72 hours after transplant compared to the rATG group, but this did not achieve statistical significance. The C1H group retained a lower absolute lymphocyte count 72 hours post-administration compared to the rATG group, which was expected based on the mechanism of C1H. There were no statistically significant differences between the two groups with regards to vasopressor requirements and time to extubation.

*Conclusions: Our data suggests that there is no difference in efficacy and safety with alemtuzumab compared to antithymocyte globulin. A larger sample size will be needed to confirm these results.

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