Outcomes associated with steroid avoidance and alemtuzumab among kidney transplant recipients

Oscar K. Serrano, Patricia Friedmann, Sayeeda Ahsanuddin, Carlos Millan, Almog Ben-Yaacov, Liise K. Kayler

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and objectives Alemtuzumab is a humanized anti-CD52 monoclonal antibody used as induction in kidney transplantation (KTX) since 2003. Few studies have evaluated long-term outcomes of this agent or changes in outcomes over time. Design, setting, participants, & measurements A retrospective cohort study was performed examining United States registry data from 2003 to 2014 of primary KTX recipients receiving induction with alemtuzumab (AZ; n=5521) or antithymocyte globulin (ATG; n=8504) and maintenance immunosuppression with tacrolimus and mycophenolate mofetil and early withdrawal of steroids. The primary outcome was overall death-censored graft survival (DCGS), and secondary outcomes were overall patient survival and 1-year acute rejection. Multivariate models were fit with donor, recipient, and transplant covariates. Because poorer outcomes with AZ may occur from a learning curve impact with the use of a new medication, transplant year was categorized into three time periods to evaluate outcomes over time (2003-2005, 2006-2008, ≥2009), and an interaction term of induction type with transplant year category was included in all models to test for era impacts. Results On multivariate analysis of DCGS there was a significant interaction between AZ and era (P

Original languageEnglish (US)
Pages (from-to)2030-2038
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume10
Issue number11
DOIs
StatePublished - Nov 6 2015

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Steroids
Graft Survival
Kidney
Mycophenolic Acid
Transplants
Learning Curve
Antilymphocyte Serum
Tacrolimus
Kidney Transplantation
Immunosuppression
Registries
Cohort Studies
Multivariate Analysis
Retrospective Studies
Monoclonal Antibodies
Maintenance
Tissue Donors
Survival
Transplant Recipients
alemtuzumab

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Outcomes associated with steroid avoidance and alemtuzumab among kidney transplant recipients. / Serrano, Oscar K.; Friedmann, Patricia; Ahsanuddin, Sayeeda; Millan, Carlos; Ben-Yaacov, Almog; Kayler, Liise K.

In: Clinical Journal of the American Society of Nephrology, Vol. 10, No. 11, 06.11.2015, p. 2030-2038.

Research output: Contribution to journalArticle

Serrano, Oscar K. ; Friedmann, Patricia ; Ahsanuddin, Sayeeda ; Millan, Carlos ; Ben-Yaacov, Almog ; Kayler, Liise K. / Outcomes associated with steroid avoidance and alemtuzumab among kidney transplant recipients. In: Clinical Journal of the American Society of Nephrology. 2015 ; Vol. 10, No. 11. pp. 2030-2038.
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