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25 January 2019 : Letter/Correspondence  

Good Results with Individually Adapted Long-Term Immunosuppression Following Alemtuzumab Versus ATG Induction Therapy in Combined Kidney-Pancreas Transplantation: A Single-Center Report

Claudia Bösmüller1ABCDEF*, Franka Messner1BC, Christian Margreiter1D, Robert Öllinger2D, Manuel Maglione1D, Rupert Oberhuber1D, Stefan Scheidl1D, Hannes Neuwirt3D, Dietmar Öfner1E, Raimund Margreiter1AE, Stefan Schneeberger1DE

DOI: 10.12659/AOT.911712

Ann Transplant 2019; 24:52-56

Abstract

Retrospective analysis of the long-term results of a randomized controlled trial comparing alemtuzumab (ALEM) and antithymocyte globulin (ATG) as induction therapy in simultaneous pancreas-kidney transplantation (SPK) to address individualized long-term immunosuppression. Between 2006 and 2010 a total of 30 SPKs were randomized to treatment with ALEM plus tacrolimus (TAC) monotherapy (Group A, n=14) versus ATG induction plus TAC, mycophenolate mofetil (MMF) and steroids (Group B, n=16), followed by individualized long-term immunosuppression. We here present the long-term results for graft survival, graft function, and major complications. The 9-year patient survival rates in Groups A and Group B were 92.9% and 86.7% respectively; pancreas graft survival was 75.0% and 65.0% respectively; renal graft survival was 83.1% and 93.8% respectively. Long-term graft function was excellent with a creatinine of 1.5 mg/dL and 1.4 mg/dL, fasting glycemia of 104 mg/dL and 102 mg/dL, hemoglobin (Hb) A1c of 5.4 g% and 5.6 g% in Group A and Group B, respectively. Major complications were comparable in both groups. Good long-term results for patient, pancreas graft and kidney graft survival were achieved in both groups with individually adapted maintenance immunosuppression. ALEM is a valid induction therapy.

Keywords: Immunosuppressive Agents, Kidney Transplantation, Pancreas Transplantation, alemtuzumab, Antilymphocyte Serum, Diabetes Mellitus, Type 1, Graft Rejection, Graft Survival, Immunosuppression Therapy, Survival Rate

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358