A randomized trial of alemtuzumab vs. anti‐thymocyte globulin induction in renal and pancreas transplantation
- 24 October 2007
- journal article
- research article
- Published by Wiley in Clinical Transplantation
- Vol. 22 (1), 41-49
- https://doi.org/10.1111/j.1399-0012.2007.00742.x
Abstract
The role of alemtuzumab as an immunosuppressive agent is evolving. We conducted a prospective randomized trial comparing alemtuzumab and rabbit anti-thymocyte globulin (rATG) induction in adult kidney and pancreas transplantation using similar maintenance immunosuppression. Between February 1, 2005 and June 15, 2006 (median follow-up six months), 98 patients were randomized either to alemtuzumab (n = 48) or to rATG (n = 50) induction; 77 (79%) underwent kidney alone (KA) transplant, 17 (17%) pancreas-kidney transplant, and four (4%) pancreas after kidney transplant. Of 77 KA transplants, 66 (86%) were from deceased donors and 31 (40%) from expanded criteria donors (ECD). Re-transplantation, HLA-match, antibody titer, ECD, race, cytomegalovirus status, steroid use, delayed graft function, preservation time, and immunological risk were similar between the two induction groups. Patient, kidney, and pancreas graft survival rates were 100%, 96%, and 95%, respectively. Survival, initial length of stay, delayed graft function, and overall acute rejection rates were similar between alemtuzumab and rATG groups, but acute rejection occurred in nine (20%) rATG patients compared with zero (0%) alemtuzumab patients who received KA transplants (p = 0.007). Mean induction costs differed in the alemtuzumab ($1474) and rATG ($4996, p < 0.001) groups. In the short term after kidney and pancreas transplantation, alemtuzumab and rATG induction therapies are similarly safe and effective.Keywords
This publication has 24 references indexed in Scilit:
- Intermediate-Term Outcomes With Expanded Criteria Deceased Donors in Kidney TransplantationAnnals of Surgery, 2006
- Optimal use of older donors and recipients in kidney transplantationSurgery, 2006
- Alemtuzumab Induction and Prednisone-Free Maintenance Immunotherapy in Simultaneous Pancreas-Kidney Transplantation Comparison With Rabbit Antithymocyte Globulin Induction – Long-Term ResultsAmerican Journal of Transplantation, 2006
- Alemtuzumab Induction and Prednisone‐Free Maintenance Immunotherapy in Kidney Transplantation: Comparison with Basiliximab Induction—Long‐Term ResultsAmerican Journal of Transplantation, 2005
- Randomized comparison of triple therapy and antithymocyte globulin induction treatment after simultaneous pancreas-kidney transplantationKidney International, 1998
- EVALUATION OF PANCREAS TRANSPLANT NEEDLE BIOPSYTransplantation, 1997
- INDUCTION IMMUNOSUPPRESSION WITH ANTILYMPHOCYTE GLOBULIN OR OKT3 IN CADAVER KIDNEY TRANSPLANTATIONTransplantation, 1994
- PREVENTION OF REJECTION AND GRAFT LOSS WITH AN AGGRESSIVE QUADRUPLE IMMUNOSUPPRESSIVE THERAPY REGIMEN IN CHILDREN AND ADOLESCENTSTransplantation, 1994
- Monoclonal antibodies in organ transplantationBiotechnology Advances, 1993
- PROPHYLACTIC USE OF OKT3 MONOCLONAL ANTIBODY IN CADAVER KIDNEY RECIPIENTS UTILIZATION OF OKT3 AS THE SOLE IMMUNOSUPPRESSIVE AGENTTransplantation, 1986