Evaluation of alemtuzumab versus basiliximab induction: A retrospective cohort study in lung transplant recipients

Laura K. Whited, Michael J. Latran, Zubair A. Hashmi, I-Wen Wang, Thomas C. Wozniak, Michael D. Duncan, David W. Roe, Maher A. Baz, Chadi Hage

Research output: Contribution to journalArticle

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Abstract

Background. Acute cellular rejection (ACR) is a major early complication after lung transplantation (LT) and is a risk factor for chronic rejection. Induction immunosuppression has been used as a strategy to reduce early ACR. Recently, our LT program changed our primary induction protocol from basiliximab with standardmaintenance immunosuppression to alemtuzumab induction with reduced dose maintenance immunosuppression. The objective of this study was to compare incidence of ACR after this change in the first 6 months after transplantation. Methods. A retrospective, cohort review of patients 18 years or older, which received their first LT between January 2010 and September 2012. Results. The primary outcome was comparison of average lung biopsy scores at 6months. Secondary outcomes included development of grade A2 or higher rejection, infectious outcomes, overall graft and patient survival. At 6 months, the average biopsy score was significantly lower in the alemtuzumab group than the basiliximab group (0.12 ± 0.29 vs 0.74 ± 0.67; P <0.0001) (Table 2). Grade 2 or higher rejection was significantly higher in the basiliximab group (P <0.0001). Conclusions. Alemtuzumab provided superior outcomes in regard to average biopsy score and lower incidence of grade 2 or higher rejection at 6months. There were no differences in infectious complications or overall graft or patient survival between the 2 groups.

Original languageEnglish (US)
Pages (from-to)2190-2195
Number of pages6
JournalTransplantation
Volume99
Issue number10
DOIs
StatePublished - 2015

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Lung Transplantation
Immunosuppression
Cohort Studies
Retrospective Studies
Biopsy
Lung
Incidence
Graft Survival
varespladib methyl
Transplantation
Maintenance
Transplants
Survival
Transplant Recipients
basiliximab
alemtuzumab

ASJC Scopus subject areas

  • Transplantation

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Evaluation of alemtuzumab versus basiliximab induction : A retrospective cohort study in lung transplant recipients. / Whited, Laura K.; Latran, Michael J.; Hashmi, Zubair A.; Wang, I-Wen; Wozniak, Thomas C.; Duncan, Michael D.; Roe, David W.; Baz, Maher A.; Hage, Chadi.

In: Transplantation, Vol. 99, No. 10, 2015, p. 2190-2195.

Research output: Contribution to journalArticle

Whited, LK, Latran, MJ, Hashmi, ZA, Wang, I-W, Wozniak, TC, Duncan, MD, Roe, DW, Baz, MA & Hage, C 2015, 'Evaluation of alemtuzumab versus basiliximab induction: A retrospective cohort study in lung transplant recipients', Transplantation, vol. 99, no. 10, pp. 2190-2195. https://doi.org/10.1097/TP.0000000000000687
Whited, Laura K. ; Latran, Michael J. ; Hashmi, Zubair A. ; Wang, I-Wen ; Wozniak, Thomas C. ; Duncan, Michael D. ; Roe, David W. ; Baz, Maher A. ; Hage, Chadi. / Evaluation of alemtuzumab versus basiliximab induction : A retrospective cohort study in lung transplant recipients. In: Transplantation. 2015 ; Vol. 99, No. 10. pp. 2190-2195.
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abstract = "Background. Acute cellular rejection (ACR) is a major early complication after lung transplantation (LT) and is a risk factor for chronic rejection. Induction immunosuppression has been used as a strategy to reduce early ACR. Recently, our LT program changed our primary induction protocol from basiliximab with standardmaintenance immunosuppression to alemtuzumab induction with reduced dose maintenance immunosuppression. The objective of this study was to compare incidence of ACR after this change in the first 6 months after transplantation. Methods. A retrospective, cohort review of patients 18 years or older, which received their first LT between January 2010 and September 2012. Results. The primary outcome was comparison of average lung biopsy scores at 6months. Secondary outcomes included development of grade A2 or higher rejection, infectious outcomes, overall graft and patient survival. At 6 months, the average biopsy score was significantly lower in the alemtuzumab group than the basiliximab group (0.12 ± 0.29 vs 0.74 ± 0.67; P <0.0001) (Table 2). Grade 2 or higher rejection was significantly higher in the basiliximab group (P <0.0001). Conclusions. Alemtuzumab provided superior outcomes in regard to average biopsy score and lower incidence of grade 2 or higher rejection at 6months. There were no differences in infectious complications or overall graft or patient survival between the 2 groups.",
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