Details

Autor(en) / Beteiligte

• Harris, Taylor N.
• Szempruch, Kristen R.
• Dupuis, Robert E.
• Serrano Rodriguez, Pablo
• Toledo, Alexander H.

Titel

Alemtuzumab in Renal Retransplantation – Transplant Outcomes and Associated Infections

Ist Teil von

• Transplantation proceedings, 2021-12, Vol.53 (10), p.2888-2894

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• •Alemtuzumab for renal retransplant induction resulted in urinary tract infections, cytomegalovirus DNAemia, and BK viremia.•Development of de novo donor-specific antibodies did not result in antibody-mediated rejection after renal retransplant.•The incidence of acute rejection after alemtuzumab induction was low and survival was high. Renal retransplant patients have decreased graft survival compared with primary renal transplant patients. Alemtuzumab induction is often used at the time of retransplant; however, the literature surrounding alemtuzumab induction in renal retransplant patients is limited. In this single-center, retrospective, observational study, we aimed to determine the 1-year incidence of infections and transplant outcomes in renal retransplant patients who received alemtuzumab induction. Thirty-four patients who received alemtuzumab met inclusion criteria and were included in the final analysis. Twenty-two (64.7%) of these patients acquired infections. Of these, 7 patients (31.8%) acquired infections that resulted in hospitalization or intravenous antibiotics. The most common infections were urinary tract infections (n = 10; 29.4%), cytomegalovirus DNAemia (n = 7; 20.6%), and BK virus (n = 6; 17.6%). The use of steroid maintenance therapy after alemtuzumab induction did not increase the number of infections compared with patients with a steroid-free interval after alemtuzumab induction. The number of patients who developed de novo donor-specific antibodies (DSA) was 11 (32.4%) with only 1 of these patients having DSA before retransplantation. The incidence of acute cellular rejection was 2.9% (n = 1). There was no graft loss, and patient survival was 97% (n = 33). There were no significant differences in infection rate or DSA development between alemtuzumab and the other induction agents, antithymocyte globulin and basiliximab, among retransplanted patients. Alemtuzumab induction in renal retransplant patients resulted in similar bacterial and viral infection rates as previously reported in the literature and did not negatively impact graft and patient survival.