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- Title
Campath induction in HCV and HCV/HIV-seropositive kidney transplant recipients.
- Authors
Vivanco, Marcelo; Friedmann, Patricia; Xia, Yu; Klair, Tarunjeet; Marfo, Kwaku; Boccardo, Graciela; Greenstein, Stuart; Chapochnick-Friedmann, Javier; Kinkhabwala, Milan; Ajaimy, Maria; Lubetzky, Michelle L.; Akalin, Enver; Kayler, Liise K.
- Abstract
Alemtuzumab ( AZ) induction in hepatitis C-seropositive (HCV+) kidney transplant ( KTX) recipients may negatively affect patient survival; however, available information is scant. Using US registry data from 2003 to 2010 of adult HCV+ deceased-donor KTXs ( n = 4910), we examined outcomes by induction agent - AZ ( n = 294), other T cell-depleting agents, ( n = 2033; T cell), IL-2 receptor blockade ( n = 1135; IL-2RAb), and no induction ( n = 1448). On multivariate analysis, induction therapy was associated with significantly better overall patient survival with AZ [adjusted hazards ratio ( aHR) 0.64, 95% confidence interval ( CI) 0.45, 0.92], T cell (aHR 0.52, 95% CI 0.41, 0.65) or IL-2RAb (aHR 0.67, 95% CI 0.53, 0.87), compared to no induction. A significant protective effect was also seen with AZ (aHR 0.63, 95% CI 0.40, 0.99), T cell (aHR 0.62, 95% CI 0.49, 0.78), and IL2R-Ab (aHR 0.62, 95% CI 0.47, 0.82) in terms of death-censored graft survival relative to no induction. There were 88 HIV+/HCV+ coinfected recipients. Compared to noninduction, any induction (i.e. three induction groups combined) was associated with similar overall patient survival ( P = 0.2255) on univariate analysis. Induction therapy with AZ, other T cell-depleting agents, or IL-2RAb in HCV+ KTX is associated with better patient and death-censored graft survival compared to noninduction. In HCV/HIV coinfected patients, induction is not contraindicated.
- Subjects
ALEMTUZUMAB; HEPATITIS C; KIDNEY transplantation; T cells; UNIVARIATE analysis
- Publication
Transplant International, 2013, Vol 26, Issue 10, p1016
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.12167