Transplant Induction Protocols Offer Similar Patient, Graft Survival

Study compared single-dose alemtuzumab and multiple-dose rabbit anti-thymocyte globulin.
Study compared single-dose alemtuzumab and multiple-dose rabbit anti-thymocyte globulin.

SAN FRANCISCO—Single-dose alemtuzumab and multiple-dose rabbit anti-thymocyte globulin (rATG) induction are associated with similar overall long-term patient and graft survival as well as rates of malignancy in kidney and kidney/pancreas transplant patients, according to a new study presented at the 2014 World Transplant Congress.

Jeffrey Rogers, MD, from Wake Forest Baptist Health in Winston Salem, NC, and his colleagues conducted a prospective randomized study comparing single-dose alemtuzumab (30 mg) to alternate day rATG induction in 218 kidney transplant or kidney/pancreas transplant recipients who received their allografts from February 1, 2005 to August 24, 2007. All patients received tacrolimus and mycophenolate mofetil. The median follow-up was 84 months.

The 7-year patient and graft survival rates were 75% and 62%, respectively, in the alemtuzumab group and 72% and 60%, respectively, in the rATG group.

Alemtuzumab induction was less commonly associated with biopsy-proven acute kidney rejection (BPAR) than rATG. This difference did not translate to less chronic allograft nephropathy or graft loss at a median follow-up of 7 years.

The vast majority of BPAR events occurred early in both induction groups, Dr. Rogers said. The study showed that late BPAR was not more common with 1 agent over another.

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