Alemtuzumab Induction Allows Better Rejection Free Graft Survival in Comparison to Basiliximab Although with Increased Post Transplant Viral Infections.
1Renal Transplant Surgery, Royal Liverpool and Broadgreen University Hospital, Liverpool, United Kingdom
2Transplant Surgery, Manchester Royal Infirmary, Manchester, United Kingdom.
Meeting: 2016 American Transplant Congress
Abstract number: C50
Keywords: Graft function, Immunosuppression, Induction therapy, Kidney transplantation
Session Information
Session Name: Poster Session C: Clinical Science - Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Introduction: 3C study concluded that in comparison to basiliximab, alemtuzumab induction reduces the risk of biopsy proven acute rejection (BPAR) in renal transplant recipients. In our experience Alemtuzumab and Basiliximab induction safely provided steroid-free maintenance immunosuppressive regimen but the rejection and infection incidence were not established. We compared alemtuzumab and basiliximab induction followed by standard two drug maintenance immunosuppression to assess rejection & infection rate.
Methods: Data was collected retrospectively from patients transplanted between 1/08/2009 to 31/12/2013. 436 patients were analysed, 235 received basiliximab, 198 received alemtuzumab and data was not available for 3 patients. Tacrolimus and MMF were used as maintenance immunosuppression in both groups. Demographics, BPAR episodes, viral infections, and creatinine levels were analyzed using Medcalc 13.0 statistical software.
Results: Review of the data showed no significant differences for demographic details, graft survival, patient survival.
basiliximab group had increased incidence of BPAR, 52/235,22.1% as compared to alemtuzumab 15/198, 7.5% (Yates correction <0.001, Fischers Exact test one tailed p<.0001). Median creatinine level at 6 weeks was 128± 21 [micro]mol/L (Basiliximab) & 115± 16 [micro]mol/L (Alemtuzumab).
On the contrary, incidence of Viral infections was higher in the aemtuzumab group vs basiliximab [CMV (77/198 vs 57/235, Fischer Exact test one tailed p<0.0002, Pearson Test p< 0.0004), BK (34/198 vs 17/235, Fischers Exact test one tailed p<0.0006)].
Conclusion: Alemtuzumab induction significantly reduces the incidence of rejection but at the cost of increased viral infections. Our Study corroborates the 3C Trial findings. Further review of data over time will assess long term graft outcomes.
CITATION INFORMATION: Siddagangaiah V, Sharma H, Lal N, Rai J, Howse M, Ridgway D, Sharma A, Hammad A, Mehra S. Alemtuzumab Induction Allows Better Rejection Free Graft Survival in Comparison to Basiliximab Although with Increased Post Transplant Viral Infections. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Siddagangaiah V, Sharma H, Lal N, Rai J, Howse M, Ridgway D, Sharma A, Hammad A, Mehra S. Alemtuzumab Induction Allows Better Rejection Free Graft Survival in Comparison to Basiliximab Although with Increased Post Transplant Viral Infections. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/alemtuzumab-induction-allows-better-rejection-free-graft-survival-in-comparison-to-basiliximab-although-with-increased-post-transplant-viral-infections/. Accessed May 16, 2025.« Back to 2016 American Transplant Congress