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 October 27, 2020.
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