Alemtuzumab Induction Is Safe, and Permits the Avoidance of Steroids in the Majority of Renal Transplant Recipients.
1Renal Unit, St James's Hospital, Leeds, United Kingdom
2Organ Donation and Transplantation Studies, NHS Blood and Transplant, Bristol, United Kingdom
3West London Renal and Transplant, Hammersmith Hospital, London, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: B180
Keywords: Adverse effects, Induction therapy, Outcome
Session Information
Session Name: Poster Session B: Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Introduction
The introduction of alemtuzumab into routine clinical use has been hindered by safety concerns surrounding its prolonged effect on the lymphoid compartment. Here we report the updated UK experience of alemtuzumab in standard risk renal transplant recipients.
Materials and Methods
Data was extracted from the UK Transplant Registry held by NHS Blood and Transplant. Standard risk adults who received their first renal transplant between 2005 and 2013 were divided into groups according to the induction agent, and further divided into deceased donor and live donor recipients. Outcomes were measured comparing those who had received alemtuzumab, with a control group comprising of patients who received any other induction agent, and patients with no induction agent documented.
Results
13816 patients were included in the analysis. There was no difference in patient or graft survival between the two groups. In deceased donor recipients, alemtuzumab was associated with an improved rejection-free survival (p<0.0001, log-rank test), with an increase in median time to rejection from 43 days to 146 days. A greater proportion of these patients remained steroid-free at all time points (1year 83.4% vs 25%, 3 year 80.7% vs 33.3%, 5 year 82.7% vs 37.3%). In the live donor group, alemtuzumab induction did not show evidence of an effect on rejection free survival but it did permit a larger proportion of patients to remain steroid-free, whilst maintaining good graft function. The aetiology of graft failure was similar across all groups.
Discussion
Despite concerns over long term safety regarding the use of alemtuzumab in renal transplant recipients, UK registry data is reassuring suggesting similar overall performance to alternative induction agents. However alemtuzumab does permit significantly higher numbers of patients to avoid steroids without any obvious penalty.
CITATION INFORMATION: Seitz A, Robb M, Ahmad N, McLean A, Taube D, Johnson R, Baker R. Alemtuzumab Induction Is Safe, and Permits the Avoidance of Steroids in the Majority of Renal Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Seitz A, Robb M, Ahmad N, McLean A, Taube D, Johnson R, Baker R. Alemtuzumab Induction Is Safe, and Permits the Avoidance of Steroids in the Majority of Renal Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/alemtuzumab-induction-is-safe-and-permits-the-avoidance-of-steroids-in-the-majority-of-renal-transplant-recipients/. Accessed May 22, 2025.« Back to 2017 American Transplant Congress