Experience With Alemtuzumab (Campath-1H) as Induction Agent in Renal Transplantation Followed by Steroid-Free Immunosuppression

Baez, Y.; Girón, Fernando Fernández; Niño-Murcia, Alejandro; Rodríguez, J.; Salcedo, S.

doi:10.1016/j.transproceed.2008.02.026

Cited by 17 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, alemtuzumab is often used in "steroid-free" maintenance regimens. [63][64][65] Adjusting for prednisone use would therefore adjust away the manner in which these agents were combined in real-world practice. However, we performed supplementary analyses restricted to pairs who received tacrolimus and either mycophenolate mofetil or mycophenolate sodium, the most common oral immunosuppression regimen for KTRs.…”

Section: Matching On Recipient and Donor Characteristicsmentioning

confidence: 99%

Comparing Outcomes between Antibody Induction Therapies in Kidney Transplantation

Koyawala¹,

Silber

Rosenbaum

et al. 2017

JASN

View full text Add to dashboard Cite

Kidney transplant recipients often receive antibody induction. Previous studies of induction therapy were often limited by short follow-up and/or absence of information about complications. After linking Organ Procurement and Transplantation Network data with Medicare claims, we compared outcomes between three induction therapies for kidney recipients. Using novel matching techniques developed on the basis of 15 clinical and demographic characteristics, we generated 1:1 pairs of alemtuzumab-rabbit antithymocyte globulin (rATG) (5330 pairs) and basiliximab-rATG (9378 pairs) recipients. We used paired Cox regression to analyze the primary outcomes of death and death or allograft failure. Secondary outcomes included death or sepsis, death or lymphoma, death or melanoma, and healthcare resource utilization within 1 year. Compared with rATG recipients, alemtuzumab recipients had higher risk of death (hazard ratio [HR], 1.14; 95% confidence interval [95% CI], 1.03 to 1.26; <0.01) and death or allograft failure (HR, 1.18; 95% CI, 1.09 to 1.28; <0.001). Results for death as well as death or allograft failure were generally consistent among elderly and nonelderly subgroups and among pairs receiving oral prednisone. Compared with rATG recipients, basiliximab recipients had higher risk of death (HR, 1.08; 95% CI, 1.01 to 1.16; =0.03) and death or lymphoma (HR, 1.12; 95% CI, 1.01 to 1.23; =0.03), although these differences were not confirmed in subgroup analyses. One-year resource utilization was slightly lower among alemtuzumab recipients than among rATG recipients, but did not differ between basiliximab and rATG recipients. This observational evidence indicates that, compared with alemtuzumab and basiliximab, rATG associates with lower risk of adverse outcomes, including mortality.

show abstract

Section: Matching On Recipient and Donor Characteristicsmentioning

confidence: 99%

Comparing Outcomes between Antibody Induction Therapies in Kidney Transplantation

Koyawala¹,

Silber

Rosenbaum

et al. 2017

JASN

View full text Add to dashboard Cite

show abstract

“…In Hispanic patients, 1-year graft survival was not affected by broad sensitization compared with blacks 54. Additionally, it appears that Hispanics and Asians require less immunosuppression than whites 55, 56…”

Section: Mechanisms Contributing To Disparitiesmentioning

confidence: 99%

Disparities in Kidney Transplant Outcomes: A Review

Gordon

Ladner

Caicedo

et al. 2010

Seminars in Nephrology

124

112

View full text Add to dashboard Cite

Sociocultural and socioeconomic disparities in graft survival, graft function, and patient survival in adult kidney transplant recipients are reviewed. Studies consistently document worse outcomes for black patients, patients with low income, and less education, whereas better outcomes are reported in Hispanic and Asian kidney transplant recipients. However, the distinct roles of racial/ethnic versus socioeconomic factors remain unclear. Attention to potential pathways contributing to disparities has been limited to immunological and nonimmunological factors, for which the mechanisms have yet to be fully illuminated. Interventions to reduce disparities have focused on modifying immunosuppressant regimens. Modifying access to care and health care funding policies for immunosuppressive medication coverage are also discussed. The implementation of culturally sensitive approaches to the care of transplant candidates and recipients is promising. Future research is needed to examine the mechanisms contributing to disparities in graft survival and to ultimately intervene effectively.

show abstract

“…Worse outcomes in African Americans compared to whites have been attributed to having more comorbid conditions [56], higher immunological risk due to greater variation in human leukocyte antigen polymorphisms [57][58][59][60], poorer control of hypertension [56,61]; requiring higher doses of immunosuppressive drugs [62][63][64] and variability in the pharmacokinetics of immunosuppressive drugs [65,66]. In Hispanics, there are few reports: the 1-year graft survival in Hispanics was not affected by broad sensitization compared with African Americans [67], and they need less immunosuppression [68,69]. Thus, it is unclear whether biological mechanisms adequately explain variations in transplant outcomes for Hispanics.…”

Section: Introductionmentioning

confidence: 99%

Ethnic advantages in kidney transplant outcomes: the Hispanic Paradox at work?

Gordon¹,

Caicedo

2008

Nephrology Dialysis Transplantation

View full text Add to dashboard Cite

1-year survival rates surpassing 91%, long-term graft survival remains inadequate [1]. The 3-year, 5-year and 10-year deceased donor unadjusted graft survival rates are 78.6%, 67.1% and 40.8%, respectively, among all kidney recipients in the United States (USA) [2].The loss of transplanted grafts is a major public health problem. Kidney transplantation is the treatment of choice for most patients with end-stage renal disease (ESRD) since it provides a longer length of life, better quality of life [3,4] and is more cost-effective than dialysis [5,6]. When kidney grafts fail, patients return to dialysis, creating an even greater demand for scarce kidney (re-)transplants and further burdening society with greater costs [7][8][9]. Mortality rates on dialysis following a failed kidney transplant are

show abstract

Experience With Alemtuzumab (Campath-1H) as Induction Agent in Renal Transplantation Followed by Steroid-Free Immunosuppression

Cited by 17 publications

References 16 publications

Comparing Outcomes between Antibody Induction Therapies in Kidney Transplantation

Comparing Outcomes between Antibody Induction Therapies in Kidney Transplantation

Disparities in Kidney Transplant Outcomes: A Review

Ethnic advantages in kidney transplant outcomes: the Hispanic Paradox at work?

Contact Info

Product

Resources

About