Acute Cellular Rejection and Infection Rates in Alemtuzumab vs Traditional Induction Therapy Agents for Lung and Heart Transplantation: A Systematic Review and Meta-analysis
Publication in refereed journal


Times Cited
Altmetrics Information
.

Other information
AbstractBackground and objectives. Heart and lung transplantation is a high-risk procedure, requiring intensive immunosuppressive therapy for preventing organ rejection. Alemtuzumab, a CD52-specific monoclonal antibody, is increasingly used for induction therapy compared with conventional agents. However, there has been no systematic review comparing its efficacy with traditional therapeutic drugs.

Methods. PubMed and EMBASE were searched to October 1, 2017, for articles on alemtuzumab in cardiothoracic transplant surgery. Of the 433 studies retrieved, 8 were included in the final meta-analysis.

Results. In lung transplantation, alemtuzumab use was associated with lower odds of acute cellular rejection compared with antithymocyte globulin (odds ratio [OR], 0.21; 95% CI, 0.11-0.40; P < .001), lower acute rejection rates (OR, 0.12; 95% CI, 0.03-0.55; P <.01), and lower infection rates (OR, 0.69; 95% CI, 0.35-1.36; P = .33) when compared with basiliximab. Multivariate meta-regression analysis found that mean age, male sex, single lung transplant, double lung transplant, cytomegalovirus or Epstein-Barr virus status, idiopathic pulmonary fibrosis, cystic fibrosis, and mean ischemic time did not significantly influence acute rejection outcomes. For heart transplantation, alemtuzumab use was associated with lower acute rejection rates when compared with tacrolimus (OR, 0.44; 95% CI, 0.30-0.66; P <.001).

Conclusions. Alemtuzumab use was associated with lower rejection rates when compared with conventional induction therapy agents (antithymocyte globulin, basiliximab, and tacrolimus) in heart and lung transplantation. However, this was based on observational studies. Randomized controlled trials are needed to verify its clinical use.
All Author(s) ListLi KHC, Ho JCS, Recaldin B, Gong M, Ho J, Li G, Liu T, Wu WKK, Wong MCS, Xia Y, Dong M, Tse G; International Health Informatics Study (IHIS) Network
Journal nameTransplantation Proceedings
Year2018
Month12
Volume Number50
Issue Number10
PublisherElsevier USA
Pages3739 - 3747
ISSN0041-1345
LanguagesEnglish-United Kingdom

Last updated on 2020-30-03 at 00:23