Evidence map›Paper›PMID 39636744›Full record

ArticleClinical transplantation2024

Multicenter, Real-World Clinical Evaluation of Alemtuzumab and Anti-Thymocyte Globulin for Severe Acute T Cell-Mediated Kidney Transplant Rejection.

Lukas K van Vugt, Erzsi Tegzess, Marieke van der Zwan, Marian C Clahsen-van Groningen, Brenda C M de Winter, Priya Vart, Marlies E J Reinders, Jan Stephan F Sanders, Stefan P Berger, Dennis A Hesselink

Abstract readMulticenter Study
In one paragraph

Article in Clinical transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. European society for organ transplantation clinical practice guideline on prevention and treatment of chronic lung allograft dysfunction.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Guideline
  2. Biologics in Kidney Transplantation: Why and How Should We Personalize Their Dosage?BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lukas K van VugtErasmus MC Transplant Institute, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0001-7343-0130
Erzsi TegzessDepartment of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0003-3049-1990
Marieke van der ZwanDepartment of Internal Medicine, Albert Schweitzer Hospital Dordrecht, Dordrecht, The Netherlands.ORCID https://orcid.org/0000-0002-9404-6135
Marian C Clahsen-van GroningenErasmus MC Transplant Institute, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0003-0565-9560
Brenda C M de WinterDepartment of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0002-4452-8443
Priya VartDepartment of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0001-5576-820X
Marlies E J ReindersErasmus MC Transplant Institute, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0001-9543-567X
Jan Stephan F SandersDepartment of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0002-0904-3969
Stefan P BergerDepartment of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0003-2228-4676
Dennis A HesselinkErasmus MC Transplant Institute, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0003-1871-1962

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlemtuzumab can be an alternative to rabbit anti-thymocyte globulin (rATG) to treat severe or glucocorticoid-resistant acute T cell-mediated kidney transplant rejection (TCMR). Yet, there are few reports in which these two treatments are evaluated let alone, compared. This study describes the real-world clinical experience of both therapies and compares their efficacy and toxicity.

methodsKidney transplant recipients of two Dutch transplant centers who received lymphocyte-depleting antibody therapy for severe or glucocorticoid-resistant TCMR were retrospectively evaluated. In the first, alemtuzumab was the standard treatment for this indication, in the second, it was rATG. Patient survival, graft survival and function, and the occurrence of infections and malignancies were reported and compared.

resultsOne hundred and forty-three patients treated with alemtuzumab and 57 patients with rATG were evaluated. Patient survival was not significantly different during follow-up (p = 0.55), and 5-year survival rates were 71.0% (95% confidence interval [CI]: 63.0-79.9) after alemtuzumab and 70.7% (95% CI: 58.3-85.7) after rATG. Graft survival was not significantly different during follow-up either (p = 0.24), and 5-year graft loss rates were 32.3% (95% CI: 24.2-40.5) after alemtuzumab and 29.2% (95% CI: 16.0-42.4) after rATG. The occurrence of infections and malignancies did not differ between groups.

conclusionMostly, severe TCMRs have good long-term graft survival and function after either alemtuzumab or rATG therapy. No significant differences between the two therapies were found in this real-world clinical experience. Alemtuzumab is an effective alternative to rATG for the treatment of severe TCMR.

Indexed as

AlemtuzumabAntilymphocyte SerumGraft RejectionGraft SurvivalKidney TransplantationT-LymphocytesAdultFemaleFollow-Up StudiesGlomerular Filtration RateHumansImmunosuppressive AgentsKidney Failure, ChronicKidney Function TestsMaleMiddle AgedAlemtuzumabAntilymphocyte SerumImmunosuppressive Agentsalemtuzumabefficacyrabbit anti‐thymocyte globulinT cell‐mediated kidney transplant rejectiontoxicity

Identifiers

PMID39636744
PMCPMC11620281

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.