Background:

Induction with Alemtuzumab is well documented to reduce the incidence and severity of acute rejection episodes, which may improve graft survival. Limited data are available in African American population. We are presenting our experience with Alemtuzumab (30 mg iv single dose) in African American population. Our current protocol for immunosuppression includes Alemtuzumab (30 mg iv single dose), Tacrolimus target trough level between 7-10 ng/ml, Mycophenolate mofetil (MMF) 500 mg oral twice daily, methylprednisolone 500 mg post operative day (POD) 0, 250 mg POD 1 and 125 mg POD 2 with immediate steroid withdrawal.

Methods:

We performed a retrospective chart review of 426 kidney transplants performed from November 2007 to December 2011 of which 297 recipients received Alemtuzumab for induction immunosuppression and we obtained demographic, clinical data including biopsy proven acute rejection. 1-year follow-up was available for all patients. At 3 years only 285 patients had follow up, 12 patients were lost due to various reasons or transferred to other transplant center.

Results:

-Incidence of biopsy proven acute rejection during the three-year follow up was 13% (19 of 141) in African Americans compared to 12%(35 of 285) in the study population.

-Incidence of graft failure at the end of 3 years was 6.3% (9 of 141) African Americans compared to 4.5% (13 of 285) in the study population. Graft survival was 93.7% in African Americans and 95.% in non-African Americans.

Conclusions:

In our experience Alemtuzumab is an effective agent with comparable rejection rates and allograft survival in African American and non-African American population.

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