Alemtuzumab Induction in Renal Transplantation Permits Safe Steroid Avoidance with Tacrolimus Monotherapy

• DOI: 10.1097/tp.0b013e3182a64db9
• Publication Date: 2013-09-20T09:20:04Z
• Authors: Matthew P. Welber...; Aravind Cherukuri; Chas G. Newstead; Andrew J.P. Lewin...; Niaz Ahmad; Krish Menon; Stephen G. Pollard; Padmini Prasad; Steve Tibble; Emma Giddings; Richard J. Baker
• Keywords: Basiliximab; Clinical endpoint; Immunosuppression

The use of alemtuzumab as induction immunosuppression for renal transplantation introduces the possibility long-term tacrolimus monotherapy, avoiding maintenance with both corticosteroids and mycophenolate mofetil (MMF).We conducted a single-center, prospective, open-label, randomized controlled trial comparing two steroid avoidance regimens between December 2006 November 2010. One hundred sixteen adult patients were to either basiliximab followed by MMF or monotherapy. primary endpoint was noninferiority isotopic glomerular filtration rate at 1 year; secondary endpoints included patient graft survival, incidence delayed function, severity biopsy-proven acute rejection.The groups well matched all baseline demographics. Isotopic comparable year (57±26 mL/min group 53±21 group; P=0.42). Secondary also similar groups. rejection 12 months lower in (n=6 vs. n=14 arm) just reaching statistical significance (P=0.049); however, single extra case arm when considering clinically treated removes this (P=0.082). Similar rates cardiovascular, infective, neoplastic complications observed Forty-seven (81.0%) remained on monotherapy months.Renal leads good outcomes, no major differences detected compared tacrolimus/MMF year.