5-year results of a prospective, randomized, single-center study of alemtuzumab compared with rabbit antithymocyte globulin induction in simultaneous kidney-pancreas transplantation.
Stratta RJ, Rogers J, Orlando G, et al.Transplant Proc. 2014; 46(6):1928-31.
Aims
To investigate the five year outcomes of alemtuzumab (ALEM) versus rabbit antithymocyte globulin (rATG) induction in simultaneous kidney-pancreas transplant (SKPT) patients.
Interventions
Patients were administered with ALEM (30mg intraoperatively over 2 hours) or multiple dose rATG (1.5mg/kg per dose starting intraoperatively, minimum 3 doses). Both arms received tacrolimus/mycophenolate mofetil and early steroid elimination.
Participants
46 SKPT patients.
Outcomes
The outcomes included patient survival, kidney graft survival, pancreas graft survival at one and five years, pancreas transplantation thrombosis, postoperative bleeding, other surgical complications, readmission between groups, the one and five year cumulative rates of acute rejection, bacterial and fungal infections, serum creatinine, glomerular filtration rate, HbA1c levels and C-peptide levels.
Follow-up
54-98 months (mean 69 months).
CET Conclusions
This short report is of a five year follow-up of patients receiving a simultaneous kidney and pancreas transplant as part of a large trial of 222 kidney transplant recipients in total in the study, of whom 46 received a SKPT. The two groups were comparable with respect to maintenance immunosuppression but induction was with one dose of Alemtuzumab or several doses of a rabbit antithymocyte globulin in the recipients. There was no significant difference in all the outcomes assessed, namely patient survival, graft survival, acute rejection, major infection and serum creatinine. Thus single dose Alemtuzumab and multiple dose rabbit antithymocyte globulin induction provided similar medium term patient kidney and pancreas function and survival rates. There was a suggestion that Alemtuzumab induction may be associated with less acute rejection.
Data analysis
Available case analysis
Trial registration
Not reported.