Comparison between subcutaneous and intravenous alemtuzumab: Effect of hypotension on renal transplant recipient University Hospital Hernando Moncaleano Perdomo (UHHMP) in Neiva, 20007-2008

Abstract

Objective: immunomodulators are used in renal transplant to prevent graft rejection. Alemtuzumab (Campath) is among the new promising medicines. Its intravenous administration is related to arterial hypotension which is potentially harmful to the transplanted kidney viability. This study intends to make a comparison between the arterial hypotensive effect of Alemtuzumab when subcutaneously administered and its intravenous administration. Methods: once the medical histories of patients who had renal transplant (between 2007 and 2008 at UHHMP in Neiva) were checked, it was collected the first 12 patients with Alemtuzumab intravenously administered. They were compared with the next 12 patients whose administration was subcutaneous. It was determined the effect of hypotension and the need for vasopressor agents between the groups. Results: the effect of hypotension on the intravenous group was of 66.7% (8 patients out of 12) versus 41.7% (5 patients out of 12), in the subcutaneous group. It means there was a relative risk reduction of 37.5%, indirect relative risk (OR) of 0,63 IC 95%: 0,07-1,88. The same reduction was observed regarding vasopressor requirements (dopamine): 66.7% in the intravenous group and 41.7% in the subcutaneous group. These clinical differences do not reach statistical significance. (p = 0.21). Conclusion: there is a reduction in the effect of arterial hypotension and vasopressor requirement by 37.5% when Alemtuzumab is subcutaneously administered versus intravenously administered in renal transplant recipient during anesthetic induction and as an inductor of immunosuppression.