Outcomes Associated with Steroid Avoidance and Alemtuzumab among Kidney Transplant Recipients

Clinical Journal of the American Society of Nephrology : CJASN
Oscar K SerranoLiise K Kayler

Abstract

Alemtuzumab is a humanized anti-CD52 monoclonal antibody used as induction in kidney transplantation (KTX) since 2003. Few studies have evaluated long-term outcomes of this agent or changes in outcomes over time. A retrospective cohort study was performed examining United States registry data from 2003 to 2014 of primary KTX recipients receiving induction with alemtuzumab (AZ; n=5521) or antithymocyte globulin (ATG; n=8504) and maintenance immunosuppression with tacrolimus and mycophenolate mofetil and early withdrawal of steroids. The primary outcome was overall death-censored graft survival (DCGS), and secondary outcomes were overall patient survival and 1-year acute rejection. Multivariate models were fit with donor, recipient, and transplant covariates. Because poorer outcomes with AZ may occur from a learning curve impact with the use of a new medication, transplant year was categorized into three time periods to evaluate outcomes over time (2003-2005, 2006-2008, ≥2009), and an interaction term of induction type with transplant year category was included in all models to test for era impacts. On multivariate analysis of DCGS there was a significant interaction between AZ and era (P<0.001). AZ was significantly associated w...Continue Reading

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Citations

Mar 23, 2017·Journal of the American Society of Nephrology : JASN·Neel KoyawalaPeter P Reese
May 6, 2017·Transplantation·Marcelo S SampaioKalathil K Sureshkumar
Oct 8, 2017·Transplant International : Official Journal of the European Society for Organ Transplantation·Vikas R DharnidharkaKrista L Lentine
Nov 18, 2021·Pediatric Transplantation·Sarah J KizilbashBlanche Chavers

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