CLINICAL TRANSPLANTATION Alemtuzumab Induction in Deceased Donor Kidney

Background. The use of alemtuzumab for induction therapy in kidney transplantation has been increasing. Herein is a report of graft outcomes associated with alemtuzumab induction from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database. Methods. A total of 14,362 deceased donor kidney transplants from 2003 to 2004 received no induction (n4,364), antithymocyte globulin (ATG; n4,930), interleukin-2 receptor antagonists (IL-2RA; n4,378), or alemtuzumab (n690). Acute rejection within the initial hospitalization, 6 months, and 1 year; graft survival; and rejection-free survival were examined. Graft and rejection-free survival of alemtuzumab recipients maintained with tacrolimus (FK) or cyclosporine (CSA),mycophenolatemofetil (MMF), and steroids versus no calcineurin inhibitors (CNI),MMF, and steroids were compared. Results. Alemtuzumab recipients had less acute rejection during the initial hospitalization (2.3%) than no induction, ATG, and IL-2RA (7.6%, 3.4%, and 4.8%, respectively; P0.001). There was increased acute rejection at 6months an