(1080) Comparison of Alemtuzumab to Basiliximab on Post-Operative Pulmonary Function Following Lung Transplantation

PurposeInduction immunosuppression therapies such as Alemtuzumab and Basiliximab are often used to reduce the risk of allograft rejection in lung transplantation. Prior studies have examined their safety profiles and effects on acute rejection; however, limited literature have described their impact on lung function. To elucidate any differences between Alemtuzumab and Basiliximab, changes in pulmonary function tests (PFTs) were compared between these two induction methods.MethodsA retrospective cohort study was conducted with patients over 18 years old that received lung transplants at our quaternary academic center from 2012 to 2022. Pre-operative and post-operative FEV1 (% predicted) and FEV1/FVC were collected and fold changes between pre-operative and post-operative PFTs were calculated. ANOVA and t-tests were used to test for any significance in associations between induction method and changes in PFTs.ResultsA total of 967 patients were included in this study, with 408 treated with Alemtuzumab and 559 treated with Basiliximab. After separating the patients by induction method, post-operative FEV1 and FEV1/FVC increased by 80.75% and 54.19% respectively for Alemtuzumab and by 71.51% and 43.04% for Basiliximab compared to pre-operative values. After controlling for donor, recipient, and intraoperative characteristics, this difference was found to not be statistically significant for both FEV1 (p-value=0.1995) and FEV1/FVC (p-value=0.8446). Furthermore, both Alemtuzumab and Basiliximab demonstrated increasing FEV1 from 6 months to 2 years and declining FEV1/FVC with statistically insignificant differences.ConclusionOur study suggests that patients who received Alemtuzumab and Basiliximab for induction immunosuppression during lung transplantation at our hospital observed similar improvements in pulmonary function. Limitations of this study includes missing long-term PFT data for patients that underwent lung transplantation after 2019. Induction immunosuppression therapies such as Alemtuzumab and Basiliximab are often used to reduce the risk of allograft rejection in lung transplantation. Prior studies have examined their safety profiles and effects on acute rejection; however, limited literature have described their impact on lung function. To elucidate any differences between Alemtuzumab and Basiliximab, changes in pulmonary function tests (PFTs) were compared between these two induction methods. A retrospective cohort study was conducted with patients over 18 years old that received lung transplants at our quaternary academic center from 2012 to 2022. Pre-operative and post-operative FEV1 (% predicted) and FEV1/FVC were collected and fold changes between pre-operative and post-operative PFTs were calculated. ANOVA and t-tests were used to test for any significance in associations between induction method and changes in PFTs. A total of 967 patients were included in this study, with 408 treated with Alemtuzumab and 559 treated with Basiliximab. After separating the patients by induction method, post-operative FEV1 and FEV1/FVC increased by 80.75% and 54.19% respectively for Alemtuzumab and by 71.51% and 43.04% for Basiliximab compared to pre-operative values. After controlling for donor, recipient, and intraoperative characteristics, this difference was found to not be statistically significant for both FEV1 (p-value=0.1995) and FEV1/FVC (p-value=0.8446). Furthermore, both Alemtuzumab and Basiliximab demonstrated increasing FEV1 from 6 months to 2 years and declining FEV1/FVC with statistically insignificant differences. Our study suggests that patients who received Alemtuzumab and Basiliximab for induction immunosuppression during lung transplantation at our hospital observed similar improvements in pulmonary function. Limitations of this study includes missing long-term PFT data for patients that underwent lung transplantation after 2019.