Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study

Abstract During the COVID-19 pandemic our center adjusted the standard induction therapy for normal immunological risk simultaneous pancreas-kidney (SPK) transplantations from T-cell depletion by alemtuzumab (ALEM) to IL-2 receptor blocking by basiliximab (IL2R). Here, we analyze the impact of this...

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Main Authors: Tim D. A. Swaab, Robert A. Pol, Meindert J. Crop, Jan-Stephan F. Sanders, Stefan P. Berger, Hendrik S. Hofker, Stephan J. L. Bakker, Charlotte A. te Velde-Keyzer
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-06750-y
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author Tim D. A. Swaab
Robert A. Pol
Meindert J. Crop
Jan-Stephan F. Sanders
Stefan P. Berger
Hendrik S. Hofker
Stephan J. L. Bakker
Charlotte A. te Velde-Keyzer
author_facet Tim D. A. Swaab
Robert A. Pol
Meindert J. Crop
Jan-Stephan F. Sanders
Stefan P. Berger
Hendrik S. Hofker
Stephan J. L. Bakker
Charlotte A. te Velde-Keyzer
author_sort Tim D. A. Swaab
collection DOAJ
description Abstract During the COVID-19 pandemic our center adjusted the standard induction therapy for normal immunological risk simultaneous pancreas-kidney (SPK) transplantations from T-cell depletion by alemtuzumab (ALEM) to IL-2 receptor blocking by basiliximab (IL2R). Here, we analyze the impact of this change on 1 year post-transplantation outcomes. Thirty-six adult patients who underwent SPK transplantation between June 2015 and June 2023 were included, of whom 21 before February 2020 (ALEM) and 15 after February 2020 (IL2R). Patients were stratified into two groups based on the induction therapy received. One death occurred during the follow up period. A total of three pancreas and two kidney grafts were lost. No differences between kidney and pancreas graft function or rejection rates were observed. Patients receiving IL2R induction had significantly lower 30 day postoperative complication rates (34 vs. 46%, p = 0.03) and experienced fewer bacterial infections (< 6 months: 47 vs. 81%, p = 0.03). Additionally, lower rates of viral (including CMV) and fungal infections were observed. IL2R patients also had a significantly shorter hospital admission durations (14 vs. 30 days, p < 0.001). In conclusion, IL2R induction in SPK recipients was associated with similar short-term graft function and potentially improved outcomes compared to ALEM, warranting cautious interpretation due to sample size.
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spelling doaj-art-5acd03117bf04eecbf5e0ac1d7f1f9682025-08-20T03:37:29ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-06750-yShort-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective studyTim D. A. Swaab0Robert A. Pol1Meindert J. Crop2Jan-Stephan F. Sanders3Stefan P. Berger4Hendrik S. Hofker5Stephan J. L. Bakker6Charlotte A. te Velde-Keyzer7Department of Surgery, Division of Organ Donation and Transplantation, University Medical Center Groningen, University of GroningenDepartment of Surgery, Division of Organ Donation and Transplantation, University Medical Center Groningen, University of GroningenDepartment of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of GroningenDepartment of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of GroningenDepartment of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of GroningenDepartment of Surgery, Division of Organ Donation and Transplantation, University Medical Center Groningen, University of GroningenDepartment of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of GroningenDepartment of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of GroningenAbstract During the COVID-19 pandemic our center adjusted the standard induction therapy for normal immunological risk simultaneous pancreas-kidney (SPK) transplantations from T-cell depletion by alemtuzumab (ALEM) to IL-2 receptor blocking by basiliximab (IL2R). Here, we analyze the impact of this change on 1 year post-transplantation outcomes. Thirty-six adult patients who underwent SPK transplantation between June 2015 and June 2023 were included, of whom 21 before February 2020 (ALEM) and 15 after February 2020 (IL2R). Patients were stratified into two groups based on the induction therapy received. One death occurred during the follow up period. A total of three pancreas and two kidney grafts were lost. No differences between kidney and pancreas graft function or rejection rates were observed. Patients receiving IL2R induction had significantly lower 30 day postoperative complication rates (34 vs. 46%, p = 0.03) and experienced fewer bacterial infections (< 6 months: 47 vs. 81%, p = 0.03). Additionally, lower rates of viral (including CMV) and fungal infections were observed. IL2R patients also had a significantly shorter hospital admission durations (14 vs. 30 days, p < 0.001). In conclusion, IL2R induction in SPK recipients was associated with similar short-term graft function and potentially improved outcomes compared to ALEM, warranting cautious interpretation due to sample size.https://doi.org/10.1038/s41598-025-06750-yPancreas transplantationImmunosuppressionInductionAlemtuzumabBasiliximabCOVID-19
spellingShingle Tim D. A. Swaab
Robert A. Pol
Meindert J. Crop
Jan-Stephan F. Sanders
Stefan P. Berger
Hendrik S. Hofker
Stephan J. L. Bakker
Charlotte A. te Velde-Keyzer
Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study
Scientific Reports
Pancreas transplantation
Immunosuppression
Induction
Alemtuzumab
Basiliximab
COVID-19
title Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study
title_full Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study
title_fullStr Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study
title_full_unstemmed Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study
title_short Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study
title_sort short term outcome after simultaneous pancreas kidney transplantation with alemtuzumab vs basiliximab induction a single center retrospective study
topic Pancreas transplantation
Immunosuppression
Induction
Alemtuzumab
Basiliximab
COVID-19
url https://doi.org/10.1038/s41598-025-06750-y
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