Efficacy and safety of alemtuzumab, daclizumab and antithymocyte globulin in kidney transplantation

Background: Immunosuppressants fight against acute rejections by influencing humoral and cellular immune to suppress the immune function, and then improve patient/renal graft survival. Objective:To evaluate the effectiveness and safety of alemtuzumab, daclizumab and antithymocyte globulin in inducing immunosuppression in kidney transplantation. Methods:The randomized controlled trials of alemtuzumab or daclizumab versus ATG in kidney tranplantation published from 1966 to 2011 were enrolled by searching PubMed and EMBASE using Cochrane systematic review. We collected data and major outcomes. And a meta-analysis was conducted on homogeneous studies. Results and Conclusion: A total of 9 randomized controlled trials (777 patients) about kidney transplantation were included. The meta-analysis results showed that the safety items including patient/renal graft survival and acute rejection at a follow-up of 24 months had no statistical differences among the three drugs (all P > 0.05). But there was a significant difference between the infection rates of alemtuzumab and antithymocyte globulin at 36 months of follow-up (P < 0.05). The results indicate that alemtuzumab, daclizumab and antithymocyte globulin are equally effective in inducing immunosuppression at a follow-up of 24 months in kidney transplantation. However, compared to antithymocyte globulin, alemtuzumab has a lower rate of infection at a follow-up of 36 months. © 2015, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.