Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
Division of Thoracic Surgery, Medical Center Ljubljana, Ljubljana, Slovenia.
Transpl Int. 2021 Dec;34(12):2633-2643. doi: 10.1111/tri.14153. Epub 2021 Nov 16.
Alemtuzumab is a monoclonal antibody targeting CD52, increasingly used as induction therapy after transplantation. The aim of this study was to analyze the outcomes of alemtuzumab induction therapy followed by a low-dose maintenance immunosuppression in a large single-center cohort of lung transplant recipients. All patients, who received alemtuzumab induction followed by a low-dose maintenance immunosuppression were included in the analysis. Short- and long-term outcomes were analyzed. 721 lung transplant recipients, transplanted between January 2008 and June 2019, were included in this retrospective study. Freedom from higher-grade ACR at 1, 5, and 10 years was 98%, 96%, and 96%, respectively. Thirty-nine patients (5%) developed clinical AMR. Twenty-one percent of patients developed high-grade CKD. A total of 1488 infections were recorded. Sixteen percent were diagnosed within the first 3 months. Sixty-two patients (9%) developed a malignancy during follow-up. Freedom from CLAD at 1, 5, and 10 years was 94%, 72%, and 53%, respectively. Overall survival rates at 1, 5, and 10 years were 85%, 71%, and 61%, respectively. Alemtuzumab induction combined with a low-dose tacrolimus protocol is safe and associated with low rates of acute and chronic rejection, as well as an excellent long-term survival.
阿仑单抗是一种针对 CD52 的单克隆抗体，越来越多地被用作移植后的诱导治疗。本研究的目的是分析在大型单中心肺移植受者队列中使用阿仑单抗诱导治疗联合低剂量维持免疫抑制的结果。所有接受阿仑单抗诱导治疗联合低剂量维持免疫抑制的患者均纳入分析。分析了短期和长期结果。721 例肺移植受者于 2008 年 1 月至 2019 年 6 月接受了回顾性研究。1 年、5 年和 10 年时无高级别 ACR 的生存率分别为 98%、96%和 96%。39 例（5%）患者发生临床 AMR。21%的患者发生了高级别 CKD。共记录了 1488 例感染。16%的患者在 3 个月内被诊断。62 例（9%）患者在随访期间发生恶性肿瘤。1 年、5 年和 10 年时无 CLAD 的生存率分别为 94%、72%和 53%。1 年、5 年和 10 年的总生存率分别为 85%、71%和 61%。阿仑单抗诱导联合低剂量他克莫司方案是安全的，与急性和慢性排斥反应发生率低以及长期生存良好相关。
