Alemtuzumab in Elderly Renal Transplant Recipients Is Not Associated With a Poor Outcome
Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, United Kingdom.
Meeting: 2015 American Transplant Congress
Abstract number: A145
Keywords: Elderly patients, Induction therapy, Kidney transplantation, Survival
Session Information
Session Name: Poster Session A: Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
The use and choice of induction immunosuppression in elderly kidney recipients remains unresolved. Alemtuzumab has been associated with a higher risk of death and graft loss in the elderly (>65 years). The aim of our study was to explore the use of alemtuzumab in this age group.
In this retrospective, single centre study, we report the outcomes of elderly patients (>65 years) receiving a steroid sparing, tacrolimus based regime after monoclonal antibody induction (Alemtuzumab or IL-2R mabs). Steroids were stopped 7 days post transplantation and only introduced to treat rejection.
A total of 151 patients (51 females, 100 males) were included in the study. 128 of them received Alemtuzumab and 23 IL-2R mabs, and represented the two study groups, respectively. 23 (15.2%) developed post-transplantation diabetes mellitus (PTDM). 18 patients were on steroids (11.9%). During the follow–up of 52 ± 29 months, 25 patients died and 21 patients lost their grafts. Patient survival was 97.3% at 1-year and 92.4% at 3-years. Graft survival (death-censored) was 96% at 1-year and 88.1% at 3-years.
There was no difference between the groups regarding gender (p=0.340), age at transplantation (p=0.780), months on dialysis (0.391), kidney from deceased or live donor (p=0.074), pre-emptive transplantation (p=0.210), cardiac events (p=0.767), history of pre-transplantation diabetes (p=0.813), cumulative incidence of PTDM (p=0.764), prednisolone use (p=0.155), prevalence of death (p=0.542), cause of death (p=0.537) and prevalence of graft failure (p=1.0). They were more South Asians in the Alemtuzumab group (p=0.016). More patients with diagnosis of glomerulonephritis received IL-2R mabs (p=0.012), as expected per protocol.
Survival analysis shows no difference in patient (log rank p=0.605) or graft survival (log rank p=0.486) between the groups. Multivariate analysis shows that receiving a kidney from a deceased donor (p=0.043) increases the risk of death.
Alemtzumab use was not associated with poor outcomes in our study. Although the group who received IL-2R mabs was relatively small, overall kidney and patient survival in this age group was comparable with previous studies.
To cite this abstract in AMA style:
Moutzouris D-A, Koizia L, Willicombe M, Corbett R, Duncan N, Galliford J, McLean A, Taube D. Alemtuzumab in Elderly Renal Transplant Recipients Is Not Associated With a Poor Outcome [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/alemtuzumab-in-elderly-renal-transplant-recipients-is-not-associated-with-a-poor-outcome/. Accessed November 23, 2024.« Back to 2015 American Transplant Congress