The Impact of Alemtuzumab and Basiliximab Induction on Patient Survival and Time to Bronchiolitis Obliterans Syndrome in Double Lung Transplantation Recipients

Y. Furuya, S. N. Jayarajan, S. Taghavi, F. C. Cordova, N. Patel, A. Shiose, E. Leotta, G. J. Criner, T. S. Guy, G. H. Wheatley, L. R. Kaiser, Y. Toyoda

Research output: Contribution to journalArticle

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Abstract

We examined the effect of alemtuzumab and basiliximab induction therapy on patient survival and freedom from bronchiolitis obliterans syndrome (BOS) in double lung transplantation. The United Network for Organ Sharing database was reviewed for adult double lung transplant recipients from 2006 to 2013. The primary outcome was risk-adjusted all-cause mortality. Secondary outcomes included time to BOS. There were 6117 patients were identified, of whom 738 received alemtuzumab, 2804 received basiliximab, and 2575 received no induction. Alemtuzumab recipients had higher lung allocation scores compared with basiliximab and no-induction recipients (41.4 versus 37.9 versus 40.7, p < 0.001) and were more likely to require mechanical ventilation before to transplantation (21.7% versus 6.5% versus 6.2%, p < 0.001). Median survival was longer for alemtuzumab and basiliximab recipients compared with patients who received no induction (2321 versus 2352 versus 1967 days, p = 0.001). Alemtuzumab (hazard ratio 0.80, 95% confidence interval 0.67–0.95, p = 0.009) and basiliximab induction (0.88, 0.80–0.98, p = 0.015) were independently associated with survival on multivariate analysis. At 5 years, alemtuzumab recipients had a lower incidence of BOS (22.7% versus 55.4 versus 55.9%), and its use was independently associated with lower risk of developing BOS on multivariate analysis. While both induction therapies were associated with improved survival, patients who received alemtuzumab had greater median freedom from BOS.

Original languageEnglish
Pages (from-to)2334-2341
Number of pages8
JournalAmerican Journal of Transplantation
Volume16
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

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Bronchiolitis Obliterans
Lung Transplantation
Survival
Multivariate Analysis
Lung
basiliximab
alemtuzumab
Artificial Respiration
Transplantation
Databases
Confidence Intervals
Mortality
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

The Impact of Alemtuzumab and Basiliximab Induction on Patient Survival and Time to Bronchiolitis Obliterans Syndrome in Double Lung Transplantation Recipients. / Furuya, Y.; Jayarajan, S. N.; Taghavi, S.; Cordova, F. C.; Patel, N.; Shiose, A.; Leotta, E.; Criner, G. J.; Guy, T. S.; Wheatley, G. H.; Kaiser, L. R.; Toyoda, Y.

In: American Journal of Transplantation, Vol. 16, No. 8, 01.08.2016, p. 2334-2341.

Research output: Contribution to journalArticle

Furuya, Y, Jayarajan, SN, Taghavi, S, Cordova, FC, Patel, N, Shiose, A, Leotta, E, Criner, GJ, Guy, TS, Wheatley, GH, Kaiser, LR & Toyoda, Y 2016, 'The Impact of Alemtuzumab and Basiliximab Induction on Patient Survival and Time to Bronchiolitis Obliterans Syndrome in Double Lung Transplantation Recipients', American Journal of Transplantation, vol. 16, no. 8, pp. 2334-2341. https://doi.org/10.1111/ajt.13739
Furuya, Y. ; Jayarajan, S. N. ; Taghavi, S. ; Cordova, F. C. ; Patel, N. ; Shiose, A. ; Leotta, E. ; Criner, G. J. ; Guy, T. S. ; Wheatley, G. H. ; Kaiser, L. R. ; Toyoda, Y. / The Impact of Alemtuzumab and Basiliximab Induction on Patient Survival and Time to Bronchiolitis Obliterans Syndrome in Double Lung Transplantation Recipients. In: American Journal of Transplantation. 2016 ; Vol. 16, No. 8. pp. 2334-2341.
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abstract = "We examined the effect of alemtuzumab and basiliximab induction therapy on patient survival and freedom from bronchiolitis obliterans syndrome (BOS) in double lung transplantation. The United Network for Organ Sharing database was reviewed for adult double lung transplant recipients from 2006 to 2013. The primary outcome was risk-adjusted all-cause mortality. Secondary outcomes included time to BOS. There were 6117 patients were identified, of whom 738 received alemtuzumab, 2804 received basiliximab, and 2575 received no induction. Alemtuzumab recipients had higher lung allocation scores compared with basiliximab and no-induction recipients (41.4 versus 37.9 versus 40.7, p < 0.001) and were more likely to require mechanical ventilation before to transplantation (21.7{\%} versus 6.5{\%} versus 6.2{\%}, p < 0.001). Median survival was longer for alemtuzumab and basiliximab recipients compared with patients who received no induction (2321 versus 2352 versus 1967 days, p = 0.001). Alemtuzumab (hazard ratio 0.80, 95{\%} confidence interval 0.67–0.95, p = 0.009) and basiliximab induction (0.88, 0.80–0.98, p = 0.015) were independently associated with survival on multivariate analysis. At 5 years, alemtuzumab recipients had a lower incidence of BOS (22.7{\%} versus 55.4 versus 55.9{\%}), and its use was independently associated with lower risk of developing BOS on multivariate analysis. While both induction therapies were associated with improved survival, patients who received alemtuzumab had greater median freedom from BOS.",
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AU - Cordova, F. C.

AU - Patel, N.

AU - Shiose, A.

AU - Leotta, E.

AU - Criner, G. J.

AU - Guy, T. S.

AU - Wheatley, G. H.

AU - Kaiser, L. R.

AU - Toyoda, Y.

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