Long-term outcomes following alemtuzumab induction in lung transplantation

Brody Wehman, Bartley P. Griffith, Akshu Balwan, Zachary N. Kon, Dante A. Suffredini, Charles Evans, Jose P. Garcia, Aldo Iacono

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Abstract

Objectives: Alemtuzumab is a commonly used induction agent for solid-organ transplantation. Its use in lung transplantation with reduced immunosuppressive regimens, however, has yet to be well characterized. Methods: From November 2006 to March 2008, 20 consecutive lung transplantation patients received alemtuzumab induction with a reduced maintenance immunosuppression regimen. Twenty consecutive case-controls who underwent transplantation between 2005 and 2006 were treated with a standard immunosuppression regimen without induction. Outcome variables were patient survival, acute rejection, infection, and bronchiolitis obliterans syndrome. Results: Mean follow-up time was 1400 days in the alemtuzumab group and 1210 days in the control group. Double lung transplantation was performed in 21 patients (12 in the alemtuzumab group and 9 in the control group). There was no difference in survival between the alemtuzumab (n = 10) and control (n = 10) groups. There was also not a significant difference in time-adjusted death based on Kaplan-Meier analysis. The mean number of any grade of rejection event per patient was not significantly different (alemtuzumab 2.3 ± 2.7 vs. control 3.2 ± 2.35; P = .22). There was a trend toward the reduced incidence of infection requiring intravenous antibiotics per patient (alemtuzumab 2.4 vs. control 3.8; P = .08). The incidence of bronchiolitis obliterans syndrome was similar in both groups (alemtuzumab 55% vs. control 70%; P = .25). Conclusions: Alemtuzumab induction with reduced immunosuppression offers a comparable 5-year survival and rejection rate compared to standard-dose immunosuppression regimen.

Original languageEnglish (US)
Pages (from-to)E252-E256
JournalHeart Surgery Forum
Volume16
Issue number5
DOIs
StatePublished - Oct 1 2013

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Wehman, B., Griffith, B. P., Balwan, A., Kon, Z. N., Suffredini, D. A., Evans, C., Garcia, J. P., & Iacono, A. (2013). Long-term outcomes following alemtuzumab induction in lung transplantation. Heart Surgery Forum, 16(5), E252-E256. https://doi.org/10.1532/HSF98.2013160