title: Evaluation of Alemtuzumab Versus Basiliximab Induction: A Retrospective Cohort Study in Lung Transplant Recipients.
abstract: BACKGROUND
  Acute cellular rejection (ACR) is a major early complication after lung transplantation (LT) and is a risk factor for chronic rejection. Induction immunosuppression has been used as a strategy to reduce early ACR. Recently, our LT program changed our primary induction protocol from basiliximab with standard maintenance immunosuppression to alemtuzumab induction with reduced dose maintenance immunosuppression. The objective of this study was to compare incidence of ACR after this change in the first 6 months after transplantation.
  
  
  METHODS
  A retrospective, cohort review of patients 18 years or older, which received their first LT between January 2010 and September 2012.
  
  
  RESULTS
  The primary outcome was comparison of average lung biopsy scores at 6 months. Secondary outcomes included development of grade A2 or higher rejection, infectious outcomes, overall graft and patient survival. At 6 months, the average biopsy score was significantly lower in the alemtuzumab group than the basiliximab group (0.12 ± 0.29 vs 0.74 ± 0.67; P < 0.0001) (Table 2). Grade 2 or higher rejection was significantly higher in the basiliximab group (P < 0.0001).
  
  
  CONCLUSIONS
  Alemtuzumab provided superior outcomes in regard to average biopsy score and lower incidence of grade 2 or higher rejection at 6 months. There were no differences in infectious complications or overall graft or patient survival between the 2 groups.
authors.affiliation: 1 Department of Pharmacy, Methodist Hospital, Indiana University Health, Indianapolis, IN. 2 Department of Thoracic Transplant Surgery, Methodist Hospital, Indiana University Health, Indianapolis, IN. 3 Department of Pulmonary Critical Care Medicine, Methodist Hospital, Indiana University Health, Indianapolis, IN.
authors.forename: Laura K
authors.initials: LK
authors.lastname: Whited
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Latran
authors.forename: Zubair A
authors.initials: ZA
authors.lastname: Hashmi
authors.forename: I-Wen
authors.initials: IW
authors.lastname: Wang
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Wozniak
authors.forename: Michael D
authors.initials: MD
authors.lastname: Duncan
authors.forename: David W
authors.initials: DW
authors.lastname: Roe
authors.forename: Maher A
authors.initials: MA
authors.lastname: Baz
authors.forename: Chadi A
authors.initials: CA
authors.lastname: Hage
mesh_terms: D000328:Adult; D000368:Aged; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000077552:Basiliximab; D001706:Biopsy; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D066027:Transplant Recipients; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000074323:Alemtuzumab; D000077552:Basiliximab