Alemtuzumab Induction in Simultaneous Pancreas and Kidney Transplantation
Nephrology and Transplantation, SUNY at Buffalo, Buffalo, NY
Department of Medicine, University of Florida, Gainesville, FL
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
Department of Surgery and Transplantation, Emory University, Atlanta, GA
Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
Meeting: 2013 American Transplant Congress
Abstract number: 465
Background: Alemtuzumab is a monoclonal anti-CD52 antibody used as an induction agent in organ transplantation. Few studies have analyzed this agent in the context of simultaneous kidney-pancreas transplantation (SPKT).
Methods: We examined US registry data of SPKT recipient outcomes from 1/2002 to 10/2009 stratified by induction agent including: none, IL2 receptor blockade (IL-2RAb), alemtuzumab (AZ), and other T-cell depleting agents combined (T-cell). Results: Of 6,860 SPKT recipients induction therapy was AZ in 10%, T-cell in 49%, IL-2RAb in 18%, and none in 22%. On multivariate analysis there were no significant differences in overall patient survival, pancreas or renal allograft survival, or delayed renal graft function for the 3 induction groups compared to no induction.
| Parameters (reference group) | Alemtuzumab vs. None (aHR;95% CI) | IL2RAb vs None (aHR;95% CI) | T-Cell Depleting Agents vs. None (aHR; 95% CI) |
| Patient Mortality | 0.99 (0.73,1.34) | 0.95( 0.74, 1.22) | 0.92 (0.91, 1.26) |
| Pancreas Graft Failure | 0.97 (0.80, 1.18) | 0.91(0.76, 1.08) | 0.99 (0.86, 1.14) |
| Kidney Graft Failure | 1.16 (0.93, 1.44) | 0.83 (0.68, 1.01) | 0.88 (0.95, 1.23) |
Length of stay was significantly shorter in the AZ (11.417.3) compared to the T-cell (16.4 51.7) IL-2RAb (12.326.2), and none (16.432.7), groups (p<0.01). Those receiving AZ or T-cell were more likely to be re-hospitalized within 6 months after transplant (p<0.0001).
Conclusions: There are no differences in patient, pancreas or renal allograft survival using AZ induction. AZ may confer an advantage in the perioperative period as evidenced by a decreased hospital length of stay.
To cite this abstract in AMA style:
Zachariah M, Gregg A, Schold J, Magliocca J, Kayler L. Alemtuzumab Induction in Simultaneous Pancreas and Kidney Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/alemtuzumab-induction-in-simultaneous-pancreas-and-kidney-transplantation/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress