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Alemtuzumab induction and triple maintenance immunotherapy in kidney transplantation from donors after cardiac death.

Publication ,  Journal Article
Schadde, E; D'Alessandro, AM; Knechtle, SJ; Odorico, J; Becker, Y; Pirsch, J; Sollinger, H; Fernandez, LA
Published in: Transpl Int
July 2008

We have used alemtuzumab in combination with triple maintenance immunosuppression in renal transplantation from donors after cardiac death between 2002 and 2006. We compared outcomes of induction therapy with alemtuzumab with interleukin-2 (IL-2) receptor antagonists (RA) and anti-lymphocyte antibodies. We used a retrospective sequential study design to examine 170 recipients of kidneys from donor after cardiac death (DCD) for survival, graft survival, time to first rejection, glomerular filtration and complications. Patients were stratified into high-risk and low-risk groups based on the following criteria: panel of reactive antibodies >20%, retransplants, Afro-American race. Induction with alemtuzumab was compared with anti-thymocyte globulin (ATG) in the high-risk and with IL-2RA in the low-risk group. Patients received triple immunosuppression with steroids, mycophenolate mofetil and calcineurin inhibitors. Patient survival, graft survival, rejection rate and glomerular filtration rate did not significantly differ between patients treated with alemtuzumab versus IL-2RAs or ATG. There was a trend towards reduced graft- and patient survival in the alemtuzumab group. There was an increased incidence of cytomegalovirus (CMV) infections in the alemtuzumab-induced group and a trend towards increased BK virus and bacterial infections. Induction of DCD kidney transplants with alemtuzumab compared to IL-2RA and ATG has no significant impact on acute rejection. It appears however that CMV infections are increased in patients induced with alemtuzumab. We therefore conclude that induction with alemtuzumab does not confer any advantage over traditional induction agents.

Duke Scholars

Published In

Transpl Int

DOI

ISSN

0934-0874

Publication Date

July 2008

Volume

21

Issue

7

Start / End Page

625 / 636

Location

Switzerland

Related Subject Headings

  • Tissue Donors
  • Surgery
  • Risk Factors
  • Receptors, Interleukin-2
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Immunosuppressive Agents
  • Immunocompromised Host
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schadde, E., D’Alessandro, A. M., Knechtle, S. J., Odorico, J., Becker, Y., Pirsch, J., … Fernandez, L. A. (2008). Alemtuzumab induction and triple maintenance immunotherapy in kidney transplantation from donors after cardiac death. Transpl Int, 21(7), 625–636. https://doi.org/10.1111/j.1432-2277.2008.00642.x
Schadde, Erik, Anthony M. D’Alessandro, Stuart J. Knechtle, Jon Odorico, Yolanda Becker, John Pirsch, Hans Sollinger, and Luis A. Fernandez. “Alemtuzumab induction and triple maintenance immunotherapy in kidney transplantation from donors after cardiac death.Transpl Int 21, no. 7 (July 2008): 625–36. https://doi.org/10.1111/j.1432-2277.2008.00642.x.
Schadde E, D’Alessandro AM, Knechtle SJ, Odorico J, Becker Y, Pirsch J, et al. Alemtuzumab induction and triple maintenance immunotherapy in kidney transplantation from donors after cardiac death. Transpl Int. 2008 Jul;21(7):625–36.
Schadde, Erik, et al. “Alemtuzumab induction and triple maintenance immunotherapy in kidney transplantation from donors after cardiac death.Transpl Int, vol. 21, no. 7, July 2008, pp. 625–36. Pubmed, doi:10.1111/j.1432-2277.2008.00642.x.
Schadde E, D’Alessandro AM, Knechtle SJ, Odorico J, Becker Y, Pirsch J, Sollinger H, Fernandez LA. Alemtuzumab induction and triple maintenance immunotherapy in kidney transplantation from donors after cardiac death. Transpl Int. 2008 Jul;21(7):625–636.
Journal cover image

Published In

Transpl Int

DOI

ISSN

0934-0874

Publication Date

July 2008

Volume

21

Issue

7

Start / End Page

625 / 636

Location

Switzerland

Related Subject Headings

  • Tissue Donors
  • Surgery
  • Risk Factors
  • Receptors, Interleukin-2
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Immunosuppressive Agents
  • Immunocompromised Host
  • Humans