Ten-Year-Experience with Alemtuzumab as Induction Therapy: A Single-Center Analysis of More Than 500 Patients.

Purpose According to ISHLT increasing number of lung recipients receive induction therapy. Long-term data on the use of alemtuzumab are scarce, therefore, we aimed to review our experience and analyzed the impact of alemtuzumab. Methods Patients transplanted between 2007 and 2017, who received alemtuzumab were included in this retrospective single-center analysis. The following parameters were evaluated: survival, ACR, CLAD, malignancies and kidney function, infections incidence. Results Within the study period 525 patients received alemtuzumab as induction therapy. An episode of infection within the first year after LTx was reported in 358 patients (68%), however, only 216 of them (22%) needed hospitalization. In the same period 39 recipients (7.4%) died from infection complications. As one of the main advantages of induction therapy is the reduction of CNI, we analyzed rates of kidney insufficiency. During follow-up 94 patients (17.9%) developed kidney insufficiency (eGFR> 60 ml/min). Only two patients required chronic dialysis and one a kidney transplantation. At 1- and 5-years 98% and 97% patients were free from ACR. Three- and 5-years freedom rates from CLAD were 78.7% and 71.8%. Overall survival rates at 3- and 5-years were 79% and 74%, respectively. Conclusion This study shows that alemtuzumab is an effective induction agent with low incidence of severe infections and good survival rates. The associated reduction of CNI doses led to low incidence of kidney insufficiency and long freedom rates from severe CLAD. [ABSTRACT FROM AUTHOR]