Kidney after nonrenal transplantation-the impact of alemtuzumab induction.

Authors

• Ron Shapiro
• Amit Basu
• Henkie P Tan
• Claire Morgan
• Vivek Sharma
• Deanna Blisard
• Parmjeet S Randhawa
• Igor Dvorchik
• Jerry McCauley
• Demetrius Ellis
• J Wallis Marsh
• Steven Webber
• Geoffrey Kurland
• Kenneth R McCurry
• Kareem Abu-Elmagd
• George Mazariegos
• Thomas E Starzl

Publication/Presentation Date

9-27-2009

Abstract

BACKGROUND: Calcineurin inhibitor nephrotoxicity in nonrenal allograft recipients can lead to end-stage renal disease and the need for kidney transplantation. We sought to evaluate the role of alemtuzumab induction in this population.

PATIENTS AND METHODS: We evaluated 144 patients undergoing kidney transplantation after nonrenal transplantation between May 18, 1998, and October 8, 2007. Seventy-two patients transplanted between January 15, 2003, and October 8, 2007, received alemtuzumab induction and continued their pretransplant immunosuppression. Seventy-two patients transplanted between May 18, 1998, and July 21, 2007, did not receive alemtuzumab induction, but received additional steroids and maintenance immunosuppression. Donor and recipient demographics were comparable.

RESULTS: Overall, 1- and 3-year patient survival and renal function were comparable between the two groups. One- and 3-year graft survival was 93.0% and 75.3% in the alemtuzumab group and 83.3% and 68.7% in the no alemtuzumab group, respectively (P=0.051). The incidence of acute rejection was lower in the alemtuzumab group, 15.3%, than in the no alemtuzumab group, 41.7% (P=0.0001). The incidence of delayed graft function was lower in the alemtuzumab group, 9.7%, than in the no alemtuzumab group, 25.0% (P=0.003). The incidence of viral complications was comparable.

CONCLUSION: Alemtuzumab induction with simple resumption of baseline immunosuppression in patients undergoing kidney transplantation after nonrenal transplantation represents a reasonable immunosuppressive strategy.

Volume

88

Issue

6

First Page

799

Last Page

802

ISSN

1534-6080

Published In/Presented At

Shapiro, R., Basu, A., Tan, H. P., Morgan, C., Sharma, V., Blisard, D., Randhawa, P. S., Dvorchik, I., McCauley, J., Ellis, D., Marsh, J. W., Webber, S., Kurland, G., McCurry, K. R., Abu-Elmagd, K., Mazariegos, G., & Starzl, T. E. (2009). Kidney after nonrenal transplantation-the impact of alemtuzumab induction. Transplantation, 88(6), 799–802. https://doi.org/10.1097/TP.0b013e3181b4aaf5

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

19920779

Department(s)

Administration and Leadership

Document Type

Article