P-160

Efficacy of subcutaneous vs. intravenous Alemtuzumab induction in simultaneous kidney and pancreas transplantation

K. Hamawi, R. Corey, R. Heilman, D. Mulligan, A. Moss, H. Chakkera, N. Katariya, H. Khamash, J. Prigoff, S. Reddy
Mayo Clinic Arizona, Phoenix, USA

Objective: To compare the efficacy of Alemtuzumab induction using intravenous vs. subcutaneous route in simultaneous kidney and pancreas transplantation (SPK).

Methods: Seventy three patients received SPK transplantation at our center between January 2008 and February 2011. Group A (n=61) received Alemtuzumab 30 mg subcutaneously was compared to historic group B (n=14) who received Alemtuzumab 30 mg intravenously. Maintenance immunosuppression was similar and consisted of Tacrolimus (targeting 8-12 ng/ml during the first 3 months post transplant and 6-8 ng/ml thereafter) and Mycophenolate mofetil (1000 mg twice daily). Steroids were discontinued on the forth post operative day. Primary end point was one year allograft rejection rate. Post transplantation absolute lymphocyte count (ALC) at 1, 4, 12 months were secondary end points.

Results: No differences in recipients’ baseline demographics in respect to age, gender, ethnicity, BMI, pre transplant panel reactive antibody and C-peptide were noted. Donors’ characteristics (age, BMI and cause of death) were similar. The rate of renal allograft rejection was 29% and 14.2 % in group A and group B respectively. The rate of pancreatic allograft rejection was 16.3% and 28.5% in group A and group B respectively. Both rates were not statistically significant. There was no statistical difference of ALC between the two groups at 1, 4 and 12 months post transplantation. Group A mean ALC at one month and 12 months were 0.09 and 0.77 respectively. Group B mean ALC at one month and 12 months were 0.12 and 0.99 respectively.

Conclusions: In SPK transplantation, subcutaneous administration of Alemtuzumab has the same efficacy as the intravenous route. No differences in allograft rejection noted. More studies are needed to confirm these findings.

P-160

Efficacy of subcutaneous vs. intravenous Alemtuzumab induction in simultaneous kidney and pancreas transplantation

K. Hamawi, R. Corey, R. Heilman, D. Mulligan, A. Moss, H. Chakkera, N. Katariya, H. Khamash, J. Prigoff, S. Reddy
Mayo Clinic Arizona, Phoenix, USA

Objective: To compare the efficacy of Alemtuzumab induction using intravenous vs. subcutaneous route in simultaneous kidney and pancreas transplantation (SPK).

Methods: Seventy three patients received SPK transplantation at our center between January 2008 and February 2011. Group A (n=61) received Alemtuzumab 30 mg subcutaneously was compared to historic group B (n=14) who received Alemtuzumab 30 mg intravenously. Maintenance immunosuppression was similar and consisted of Tacrolimus (targeting 8-12 ng/ml during the first 3 months post transplant and 6-8 ng/ml thereafter) and Mycophenolate mofetil (1000 mg twice daily). Steroids were discontinued on the forth post operative day. Primary end point was one year allograft rejection rate. Post transplantation absolute lymphocyte count (ALC) at 1, 4, 12 months were secondary end points.

Results: No differences in recipients’ baseline demographics in respect to age, gender, ethnicity, BMI, pre transplant panel reactive antibody and C-peptide were noted. Donors’ characteristics (age, BMI and cause of death) were similar. The rate of renal allograft rejection was 29% and 14.2 % in group A and group B respectively. The rate of pancreatic allograft rejection was 16.3% and 28.5% in group A and group B respectively. Both rates were not statistically significant. There was no statistical difference of ALC between the two groups at 1, 4 and 12 months post transplantation. Group A mean ALC at one month and 12 months were 0.09 and 0.77 respectively. Group B mean ALC at one month and 12 months were 0.12 and 0.99 respectively.

Conclusions: In SPK transplantation, subcutaneous administration of Alemtuzumab has the same efficacy as the intravenous route. No differences in allograft rejection noted. More studies are needed to confirm these findings.