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Alemtuzumab Induction Prior to Cardiac Transplantation with Lower Intensity Maintenance Immunosuppression: One‐Year Outcomes
Author(s) -
Teuteberg J. J.,
Shullo M. A.,
Zomak R.,
Toyoda Y.,
McNamara D. M.,
Bermudez C.,
Kormos R. L.,
McCurry K. R.
Publication year - 2010
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2009.02856.x
Subject(s) - medicine , alemtuzumab , calcineurin , immunosuppression , tacrolimus , induction therapy , transplantation , heart transplantation , retrospective cohort study , surgery , urology , gastroenterology , chemotherapy
Induction therapy with alemtuzumab (C‐1H) prior to cardiac transplantation (CTX) may allow for lower intensity maintenance immunosuppression. This is a retrospective study of patients who underwent CTX at a single institution from January 2001 until April 2009 and received no induction versus induction with C‐1H on a background of tacrolimus and mycophenolate. Those with C‐1H received dose‐reduced calcineurin inhibitor and no steroids. A total of 220 patients were included, 110 received C‐1H and 110 received no induction. Recipient baseline characteristics, donor age and gender were not different between the two groups. Mean tacrolimus levels (ng/mL) for C‐1H versus no induction: months 1–3 (8.5 vs. 12.9), month 4–6 (10.2 vs. 13.0), month 7–9 (10.2 vs. 11.9) and month 10–12 (9.9 vs. 11.3) were all significantly lower for the C‐1H group, p < 0.001. There were no differences between the C‐1H and no induction groups at 12 months for overall survival 85.1% versus 93.6% p = 0.09, but freedom from significant rejection was significantly higher for the C‐1H group, 84.5% versus 51.6%, p < 0.0001. In conclusion, induction therapy after CTX with C‐1H results in a similar 12 month survival, but a greater freedom from rejection despite lower calcineurin levels and without the use of steroids.