Campath-1H induction therapy in African American and Hispanic first renal transplant recipients: 3-year actuarial follow-up.

Background: In a retrospective study of the first 75 primary renal transplant patients given alemtuzumab induction at our center, 20 were African American (27%), 32 were Hispanic (43%), and 23 were non-African American, non-Hispanic (31%).

Methods: Alemtuzumab was given intraoperatively and 4 days later (0.3 mg/kg), with planned low-dose maintenance mycophenolate mofetil (500 mg twice daily) and tacrolimus (targeted trough levels of 5 to 7 ng/ml) and no corticosteroid therapy after the first week. Median follow-up among ongoing survivors with a functioning graft was 45 months.

Results: Three-year actuarial patient and graft survival rates were 95% and 85% in African Americans, 89% and 78% in Hispanics, and 96% and 96% in non-African Americans, non-Hispanics, respectively (not significant). Bioavailability of tacrolimus was significantly lower among African Americans in comparison with the other patient subgroups (P
Conclusions: This immunosuppressive protocol appears reasonably safe for 3 years after renal transplantation but suggests higher incidences of biopsy-proven acute rejection, chronic allograft dysfunction, and borderline poorer renal function among African Americans in comparison with the other patient subgroups.