Alemtuzumab with rapid steroid taper in simultaneous kidney and pancreas transplantation: Comparison to induction with antithymocyte globulin

Kunam Sudhakar Reddy, Y. Devarapalli, M. Mazur, K. Hamawi, Harini M Chakkera, A. Moss, K. Mekeel, D. Post, R. Heilman, D. Mulligan

Research output: Contribution to journalArticle

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Abstract

We compared our experience with alemtuzumab induction and rapid steroid taper (RST) in simultaneous kidney and pancreas transplantation (SKPT) with a historic control group who received rabbit antithymocyte globulin (r-ATG) induction with RST. 74 SKPTs performed at our center between January 2005 to November 2008 who underwent immunosuppression with RST in combination with r-ATG induction (n = 33; 1.5 mg/kg × 4 for a total dose of 6 mg/kg) or alemtuzumab induction (n = 41; 30 mg single dose). Maintenance immunosuppression consisted of tacrolimus and mycophenolate mofetil. Steroids were discontinued after postoperative day 4. Recipient and transplant characteristics were similar between the 2 groups, with 82% of the r-ATG and 80% of the alemtuzumab group steroid free at 1 year. The rate of clinical acute rejection episodes was 12% in the r-ATG group and 15% in the alemtuzumab group. The rates of cytomegalovirus (CMV) infection, BK nephropathy, and graft survival were similar between the 2 groups. There was no difference in mean serum creatinine, calculated GFR, or fasting blood sugar at 1 year between the 2 groups, whereas glycosylated hemoglobin (HbA1c) was lower at 1 year in the alemtuzumab (5.3 ± 0.4) versus the r-ATG group (5.6 ± 0.4; P = .0021). Induction with r-ATG or alemtuzumab with RST was safe and effective in SKPT. The incidences of acute rejection episodes, CMV infection, and BK nephropathy were similar. Mean HbA1C at 1 year was lower among the alemtuzumab group. Further long-term follow-up is needed to confirm these results.

Original languageEnglish (US)
Pages (from-to)2006-2008
Number of pages3
JournalTransplantation Proceedings
Volume42
Issue number6
DOIs
StatePublished - Jul 2010

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Pancreas Transplantation
Antilymphocyte Serum
Kidney Transplantation
Steroids
Rabbits
Cytomegalovirus Infections
Immunosuppression
Mycophenolic Acid
Glycosylated Hemoglobin A
Tacrolimus
Graft Survival
alemtuzumab
Blood Glucose
Fasting
Creatinine
Maintenance
Control Groups
Incidence
Serum

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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Alemtuzumab with rapid steroid taper in simultaneous kidney and pancreas transplantation : Comparison to induction with antithymocyte globulin. / Reddy, Kunam Sudhakar; Devarapalli, Y.; Mazur, M.; Hamawi, K.; Chakkera, Harini M; Moss, A.; Mekeel, K.; Post, D.; Heilman, R.; Mulligan, D.

In: Transplantation Proceedings, Vol. 42, No. 6, 07.2010, p. 2006-2008.

Research output: Contribution to journalArticle

Reddy, Kunam Sudhakar ; Devarapalli, Y. ; Mazur, M. ; Hamawi, K. ; Chakkera, Harini M ; Moss, A. ; Mekeel, K. ; Post, D. ; Heilman, R. ; Mulligan, D. / Alemtuzumab with rapid steroid taper in simultaneous kidney and pancreas transplantation : Comparison to induction with antithymocyte globulin. In: Transplantation Proceedings. 2010 ; Vol. 42, No. 6. pp. 2006-2008.
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AU - Hamawi, K.

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