{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:18:31Z","timestamp":1793128711459,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Alemtuzumab can be an alternative to rabbit anti\u2010thymocyte globulin (rATG) to treat severe or glucocorticoid\u2010resistant acute T cell\u2010mediated kidney transplant rejection (TCMR). Yet, there are few reports in which these two treatments are evaluated let alone, compared. This study describes the real\u2010world clinical experience of both therapies and compares their efficacy and toxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Kidney transplant recipients of two Dutch transplant centers who received lymphocyte\u2010depleting antibody therapy for severe or glucocorticoid\u2010resistant 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and forty\u2010three patients treated with alemtuzumab and 57 patients with rATG were evaluated. Patient survival was not significantly different during follow\u2010up (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.55), and 5\u2010year survival rates were 71.0% (95% confidence interval [CI]: 63.0\u201379.9) after alemtuzumab and 70.7% (95% CI: 58.3\u201385.7) after rATG. Graft survival was not significantly different during follow\u2010up either (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.24), and 5\u2010year graft loss rates were 32.3% (95% CI: 24.2\u201340.5) after alemtuzumab and 29.2% (95% CI: 16.0\u201342.4) after rATG. The occurrence of infections and malignancies did not differ between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mostly, severe TCMRs have good long\u2010term graft survival and function after either alemtuzumab or rATG therapy. No significant differences between the two therapies were found in this real\u2010world clinical experience. Alemtuzumab is an effective alternative to rATG for the treatment of severe TCMR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70046","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T17:50:16Z","timestamp":1733421016000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Multicenter, Real\u2010World Clinical Evaluation of Alemtuzumab and Anti\u2010Thymocyte Globulin for Severe Acute T Cell\u2010Mediated Kidney Transplant Rejection"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7343-0130","authenticated-orcid":false,"given":"Lukas K.","family":"van Vugt","sequence":"first","affiliation":[{"name":"Erasmus MC Transplant Institute  Rotterdam The Netherlands"},{"name":"Department of Internal Medicine Division of Nephrology and Transplantation Erasmus MC, University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3049-1990","authenticated-orcid":false,"given":"Erzsi","family":"Tegzess","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Nephrology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9404-6135","authenticated-orcid":false,"given":"Marieke","family":"van der Zwan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Albert Schweitzer Hospital Dordrecht  Dordrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-9560","authenticated-orcid":false,"given":"Marian C.","family":"Clahsen\u2010van Groningen","sequence":"additional","affiliation":[{"name":"Erasmus MC Transplant Institute  Rotterdam The Netherlands"},{"name":"Department of Pathology Erasmus MC, University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Institute of Experimental Medicine and Systems Biology RWTH Aachen University  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4452-8443","authenticated-orcid":false,"given":"Brenda C. M.","family":"de Winter","sequence":"additional","affiliation":[{"name":"Department of Hospital Pharmacy Erasmus MC, University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5576-820X","authenticated-orcid":false,"given":"Priya","family":"Vart","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Nephrology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"},{"name":"Department of Clinical Pharmacy and Pharmacology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9543-567X","authenticated-orcid":false,"given":"Marlies E. 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