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Kidney after nonrenal transplantation-the impact of alemtuzumab induction

Shapiro, R and Basu, A and Tan, HP and Morgan, C and Sharma, V and Blisard, D and Randhawa, PS and Dvorchik, I and McCauley, J and Ellis, D and Marsh, JW and Webber, S and Kurland, G and McCurry, KR and Abu-Elmagd, K and Mazariegos, G and Starzl, TE (2009) Kidney after nonrenal transplantation-the impact of alemtuzumab induction. Transplantation, 88 (6). 799 - 802. ISSN 0041-1337

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Abstract

BACKGROUND.: Calcineurin inhibitor nephrotoxicity in nonrenal allograft recipients can lead to end-stage renal disease and the need for kidney transplantation. We sought to evaluate the role of alemtuzumab induction in this population. PATIENTS AND METHODS.: We evaluated 144 patients undergoing kidney transplantation after nonrenal transplantation between May 18, 1998, and October 8, 2007. Seventy-two patients transplanted between January 15, 2003, and October 8, 2007, received alemtuzumab induction and continued their pretransplant immunosuppression. Seventy-two patients transplanted between May 18, 1998, and July 21, 2007, did not receive alemtuzumab induction, but received additional steroids and maintenance immunosuppression. Donor and recipient demographics were comparable. RESULTS.: Overall, 1-and 3-year patient survival and renal function were comparable between the two groups. One-and 3-year graft survival was 93.0% and 75.3% in the alemtuzumab group and 83.3% and 68.7% in the no alemtuzumab group, respectively (P=0.051). The incidence of acute rejection was lower in the alemtuzumab group, 15.3%, than in the no alemtuzumab group, 41.7% (P=0.0001). The incidence of delayed graft function was lower in the alemtuzumab group, 9.7%, than in the no alemtuzumab group, 25.0% (P=0.003). The incidence of viral complications was comparable. CONCLUSION.: Alemtuzumab induction with simple resumption of baseline immunosuppression in patients undergoing kidney transplantation after nonrenal transplantation represents a reasonable immunosuppressive strategy. Copyright © 2009 by Lippincott Williams & Wilkins.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Shapiro, R
Basu, A
Tan, HP
Morgan, C
Sharma, V
Blisard, D
Randhawa, PS
Dvorchik, I
McCauley, J
Ellis, D
Marsh, JW
Webber, S
Kurland, G
McCurry, KR
Abu-Elmagd, K
Mazariegos, G
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 5 November 2009
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 88
Number: 6
Page Range: 799 - 802
DOI or Unique Handle: 10.1097/tp.0b013e3181b4aaf5
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062121607, Starzl CV No. 2248
PubMed ID: 19920779
Date Deposited: 08 Apr 2010 17:38
Last Modified: 13 Oct 2017 22:59
URI: http://d-scholarship.pitt.edu/id/eprint/5634

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