Alemtuzumab Induction with Tacrolimus Monotherapy vs TAC+MMF Bitherapy in Pancreas Transplant Recipients: 10 Year Experience
Surgery, Starzl Transplant Institute, University of Pittsburgh Medical Center, Pittsburgh, PA
Meeting: 2013 American Transplant Congress
Abstract number: C1391
PURPOSE: We report our pancreas transplantation experience with alemtuzumab (Campath-1H) induction with tacrolimus monotherapy vs. tacrolimus plus mycophenolate mofetil (MMF) bitherapy with respect to 10 year outcome data comparing rates of acute cellular rejection (ACR) as well as patient and allograft survival.
METHODS: Outcomes of 236 consecutive adult pancreas transplants between 2002 and 2012 at our center were reviewed. Overall mean follow-up was 1437 days. Pancreas transplants included 134 simultaneous kidney-pancreas transplants (SPK), 70 pancreas-after-kidney transplants (PAK), and 42 pancreas transplants alone (PTA). Pancreas transplant recipients received either tacrolimus monotherapy or tacrolimus plus MMF as maintenance immunosuppression. Rates of ACR along with patient and allograft survival were compared between monotherapy and bitherapy patient groups. A Fisher’s exact test was used to compare incidence of allograft rejection. SPSS 17 statistical package was used to calculate Kaplan-Meier survival.
RESULTS:
| N | SPK | PAK | PTA | ||||
|---|---|---|---|---|---|---|---|
| FK | 40 | 17 | 15 | 8 | |||
| FK+MMF | 196 | 107 | 55 | 34 | |||
| Patient Survival | 1yr | 2yr | 3yr | 4yr | 5yr | 7yr | 10yr |
| FK | 97.1% | 88.1% | 85.0% | 85.0% | 78.4% | 73.2% | 73.2% |
| FK+MMF | 97.7% | 96.4% | 95.6% | 93.0% | 88.3% | 80.8% | 73.1% |
| GRAFT SURVIVAL | |||||||
| FK | 80.0% | 66.8% | 61.0% | 54.9% | 51.8% | 47.5% | 47.5% |
| FK+MMF | 91.5% | 82.9% | 80.3% | 76.2% | 69.1% | 63.2% | 53.7% |
| ACR | |||||||
| FK | 20.0% | 22.5% | 25.0% | 25.0% | 25.0% | 25.0% | 25.0% |
| FK+MMF | 11.2% | 18.9% | 20.9% | 23.5% | 25.0% | 25.0% | 25.0% |
CONCLUSION: 10 year outcome data suggest that alemtuzumab induction followed by tacrolimus bitherapy is superior to monotherapy in terms of ACR rates and graft survival but not patient survival.
To cite this abstract in AMA style:
Tan H, Shapiro R, Tevar A, Donaldson J, Basu A, Sturdevant M, Lopez R, Wijkstrom M, McCauley J, Wu C, Shah N, Humar A. Alemtuzumab Induction with Tacrolimus Monotherapy vs TAC+MMF Bitherapy in Pancreas Transplant Recipients: 10 Year Experience [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/alemtuzumab-induction-with-tacrolimus-monotherapy-vs-tacmmf-bitherapy-in-pancreas-transplant-recipients-10-year-experience/. Accessed November 23, 2024.« Back to 2013 American Transplant Congress