LAUSR

Introduction: Rabbit anti-thymocyte globulin (rATG) is currently the treatment of choice for glucocorticoid-resistant, recurrent or severe acute allograft rejection (AR). However, rATG is associated with severe infusion-related side effects. Alemtuzumab is incidentally given to kidney transplant recipients as treatment for AR. In the current study, the outcomes of patients treated with alemtuzumab for AR were compared with that of patients treated with rATG for AR. Methods: The patient-, allograft-, and infection-free survival and adverse events of 116 alemtuzumab-treated patients were compared with those of 108 patients treated with rATG for AR Propensity scores were used to control for differences between the two groups. Results: Patientand allograft survival of patients treated with either alemtuzumab or rATG were not different (hazard ratio [HR] 1.14, 95%-confidence interval [CI] 0.48-2-69, p=0.77, and HR 0.82, 95%-CI 0.45-1.5, p=0.52, respectively). Infection-free survival after alemtuzumab treatment was superior compared with that of rATG-treated patients (HR 0.41, 95%-CI 0.250.68, p<0.002). Infusion-related adverse events occurred less frequently after alemtuzumab treatment and the median length of hospitalization of alemtuzumab-treated patients was 12 days shorter (p<0.001). Conclusion: Alemtuzumab therapy may be an alternative therapy for glucocorticoid-resistant, recurrent or severe acute kidney transplant rejection. The advantages of alemtuzumab over rATG are fewer infusion-related side effects, fewer infections, and a shorter hospital stay. P-11.51