The Relationship Between Age and Morbidity During the First Year Following Renal Transplantation in Patients Receiving Alemtuzumab Induction
Vanderbilt University Medical Center, Nashville.
Meeting: 2015 American Transplant Congress
Abstract number: A157
Keywords: Induction therapy, Infection, Kidney transplantation
Session Information
Session Name: Poster Session A: Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Background
The elderly (age ≥ 65) represent the largest growing patient population being listed for renal transplant. Immunosuppression in elderly patients presents a unique challenge, with limited data suggesting appropriate induction therapy. The purpose of this study was to test the effect of age on morbidity in renal transplant recipients receiving alemtuzumab induction therapy.
Methods
This single center retrospective review included all renal transplant recipients aged 65 or greater (n=71) who received alemtuzumab induction therapy from January 1, 2008 to September 31, 2013. Randomized comparison subjects were proportionally matched on the type of donor (deceased or living): age 18-34 (n=65), 35-49 (n=72), 50-64 (n=72). All patients included received alemtuzumab 30 mg IV started intra-operatively. Rates for outcome measures were stratified based on frequency distributions: infection (none, 1-2, ≥ 3), readmission (0, 1, ≥2), rejection (yes/no), and use of granulocyte colony stimulating factor (GCSF, yes/ no). All patients were followed for 1 year post transplant. The effect of age in years on outcome measures was analyzed using multivariable logistic regression models that adjusted for donor type and whether a steroid regimen was used.
Results
283 adults were included (age = 50±15, range 18 to 76; 55% male, 71% deceased donor, 60% steroid free regimen). 113 patients received a three drug maintenance regimen of tacrolimus, mycophenolate mofetil, and steroids. 170 received a two drug maintenance regimen of tacrolimus and mycophenolate mofetil. After adjusting for donor type and steroid usage there was no effect of age on the rates of culture confirmed infection (P=0.810) or readmission (P=0.226). Younger patients were more likely to have a rejection episode (P=0.005) while older patients were more likely to receive GCSF treatment (P=0.045)
Conclusions
Age is not related to the rates of culture confirmed infections or hospital readmissions during the first year following kidney transplantation in patients receiving alemtuzumab induction therapy. These data suggest that, in addition to it being a cost effective medication, alemtuzumab is a safe induction therapy regardless of age.
To cite this abstract in AMA style:
LeCorchick S, Wilson N, Truscott C, Shaffer D, Karp S, Concepcion B, Stanley M, Feurer I, Bala S. The Relationship Between Age and Morbidity During the First Year Following Renal Transplantation in Patients Receiving Alemtuzumab Induction [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-relationship-between-age-and-morbidity-during-the-first-year-following-renal-transplantation-in-patients-receiving-alemtuzumab-induction/. Accessed May 9, 2025.« Back to 2015 American Transplant Congress