Low-dose alemtuzumab induction in a tailored immunosuppression protocol for sensitized kidney transplant recipients

Background: Induction therapy is crucial in kidney transplantation and constitutes an important cornerstone for long-term allograft survival. Alemtuzumab is a depleting CD52-specific antibody with T and B cell activity, leading to prolonged lymphocyte depletion for up to 12 months, with profound immunosuppression and an associated risk of serious infections. Current concepts aim to optimize dosing strategies to reduce side effects. Here we present data from an ongoing centre protocol consisting of low-dose alemtuzumab induction and tailored immunosuppression in sensitized patients undergoing kidney transplantation.

Methods: 10-year results of the protocol were analysed. Low-dose alemtuzumab induction consisted of a single dose of 20mg intraoperatively, followed by tacrolimus and corticosteroids for initial immunosuppression, with mycophenolate mofetil suspended until a total lymphocyte count >5% or 200/µl was reached.

Results: Between 01/2007 and 04/2017, 46 patients were treat...