Background: Alemtuzumab is a powerful induction agent that depletes multiple lymphocyte cell lines resulting in leukopenia and/or neutropenia with concerns over infectious complications. This study evaluates the incidence of infectious complications in our alemtuzumab group.

Methods: Retrospective analysis of renal transplant recipients induced with alemtuzumab (AL) vs. no alemtuzumab (nAL) from 2006-2014. All infections were identified and compared using a Student's t test, Fisher's exact test, and hazard ratios (HR).

Results: 450 patients were included in the nAL group and 267 patients in the AL group. The incidence of infection within the first year after transplant in the nAL group was significantly higher (176/450, 39.1% vs. 79/267, 29.5%, p=0.01). AL induction was not associated with an increased risk of infection within the first year (HR= 1.232, 95% CI 0.9451-1.606, p=0.1228). Table 1 shows the incidence of UTI was similar however the incidence of other infections (sepsis, fungal, viral, wound, and pneumonia) were higher in the nAL group.

Conclusions: Despite concerns over an increased incidence of infections associated with AL and its post-transplant leukopenia, this effect was not seen. To the contrary a higher incidence of infections were seen in the nAL group. Further investigation will be required to understand the protective effect of AL including the incidence of immunosuppression augmentation and global immunosuppression.

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