Long-Term Outcomes following Alemtuzumab Induction in Lung Transplantation

Authors

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

DOI:

https://doi.org/10.1532/HSF98.2013160

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.

References

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Published

2013-11-11

How to Cite

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. The Heart Surgery Forum, 16(5), E252-E256. https://doi.org/10.1532/HSF98.2013160

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