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Living donor renal transplantation using alemtuzumab induction and tacrolimus monotherapy

Tan, HP and Kaczorowski, DJ and Basu, A and Unruh, M and McCauley, J and Wu, C and Donaldson, J and Dvorchik, I and Kayler, L and Marcos, A and Randhawa, P and Smetanka, C and Starzl, TE and Shapiro, R (2006) Living donor renal transplantation using alemtuzumab induction and tacrolimus monotherapy. American Journal of Transplantation, 6 (10). 2409 - 2417. ISSN 1600-6135

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Abstract

Alemtuzumab was used as an induction agent in 205 renal transplant recipients undergoing 207 living donor renal transplants. All donor kidneys were recovered laparoscopically. Postoperatively, patients were treated with tacrolimus monotherapy, and immunosuppression was weaned when possible. Forty-seven recipients of living donor renal transplants prior to the induction era who received conventional triple drug immunosuppression without antibody induction served as historic controls. The mean follow-up was 493 days in the alemtuzumab group and 2101 days in the historic control group. Actuarial 1-year patient and graft survival were 98.6% and 98.1% in the alemtuzumab group, compared to 93.6% and 91.5% in the control group, respectively. The incidence of acute cellular rejection (ACR) at 1 year was 6.8% in the alemtuzumab group and 17.0% (p < 0.05) in the historic control group. Most (81.3%) episodes of ACR in the alemtuzumab group were Banff 1 (a or b) and were sensitive to steroid pulses for the treatment of rejection. There was no cytomegalovirus disease or infection. The incidence of delayed graft function was 0%, and the incidence of posttransplant insulin-dependent diabetes mellitus was 0.5%. This study represents the largest series to date of live donor renal transplant recipients undergoing alemtuzumab induction, and confirms the short-term safety and efficacy of this approach. © 2006 The Authors.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Tan, HP
Kaczorowski, DJ
Basu, A
Unruh, M
McCauley, J
Wu, C
Donaldson, J
Dvorchik, I
Kayler, L
Marcos, A
Randhawa, P
Smetanka, C
Starzl, TEtes11@pitt.eduTES11
Shapiro, R
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 October 2006
Date Type: Publication
Journal or Publication Title: American Journal of Transplantation
Volume: 6
Number: 10
Page Range: 2409 - 2417
DOI or Unique Handle: 10.1111/j.1600-6143.2006.01495.x
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 1600-6135
Other ID: uls-drl:31735062121334, Starzl CV No. 2227
Date Deposited: 08 Apr 2010 17:38
Last Modified: 04 Feb 2019 16:55
URI: http://d-scholarship.pitt.edu/id/eprint/5613

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