Living donor renal transplantation using alemtuzumab induction and tacrolimus monotherapy.

Authors

• H P Tan
• D J Kaczorowski
• A Basu
• M Unruh
• J McCauley
• C Wu
• J Donaldson
• I Dvorchik
• L Kayler
• A Marcos
• P Randhawa
• C Smetanka
• T E Starzl
• R Shapiro

Publication/Presentation Date

10-1-2006

Abstract

Alemtuzumab was used as an induction agent in 205 renal transplant recipients undergoing 207 living donor renal transplants. All donor kidneys were recovered laparoscopically. Postoperatively, patients were treated with tacrolimus monotherapy, and immunosuppression was weaned when possible. Forty-seven recipients of living donor renal transplants prior to the induction era who received conventional triple drug immunosuppression without antibody induction served as historic controls. The mean follow-up was 493 days in the alemtuzumab group and 2101 days in the historic control group. Actuarial 1-year patient and graft survival were 98.6% and 98.1% in the alemtuzumab group, compared to 93.6% and 91.5% in the control group, respectively. The incidence of acute cellular rejection (ACR) at 1 year was 6.8% in the alemtuzumab group and 17.0% (p < 0.05) in the historic control group. Most (81.3%) episodes of ACR in the alemtuzumab group were Banff 1 (a or b) and were sensitive to steroid pulses for the treatment of rejection. There was no cytomegalovirus disease or infection. The incidence of delayed graft function was 0%, and the incidence of posttransplant insulin-dependent diabetes mellitus was 0.5%. This study represents the largest series to date of live donor renal transplant recipients undergoing alemtuzumab induction, and confirms the short-term safety and efficacy of this approach.

Volume

6

Issue

10

First Page

2409

Last Page

2417

ISSN

1600-6135

Published In/Presented At

Tan, H. P., Kaczorowski, D. J., Basu, A., Unruh, M., McCauley, J., Wu, C., Donaldson, J., Dvorchik, I., Kayler, L., Marcos, A., Randhawa, P., Smetanka, C., Starzl, T. E., & Shapiro, R. (2006). Living donor renal transplantation using alemtuzumab induction and tacrolimus monotherapy. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 6(10), 2409–2417. https://doi.org/10.1111/j.1600-6143.2006.01495.x

Disciplines

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

PubMedID

16889606

Department(s)

Administration and Leadership

Document Type

Article