Alemtuzumab Induction Reduces Early Rejection in Female Renal Allograft Recipients: A Single Center Study.

Objectives: Previous research studies have highlighted differences in rejection and graft survival across sexes that favor men. We compared delayed graft function, rejection, graft survival, and overall patient survival between sexes following alemtuzumab induction. Materials and Methods: After Internal Review Board approval, a retrospective analysis of kidney transplants completed at the University of Toledo Medical Center between March 2004 and November 2015 was conducted. Results: During the study period, 675 transplants were performed. This included 429 male patients (63.6%) and 246 female patients (36.4%). Recipient sex was not associated with delayed graft function. Acute rejection occurred less frequently in women than in men at 3 months (12.6% vs 20.7%; P = .009) and at 6 months (15.9% vs 24.6%; P = .008). Cumulative patient survival was superior in women (P = .032). Female recipient death-censored graft survival was inferior at 3 years (85.4% vs 91.6%; P = .034) and at 5 years (77.7% vs 86.9%; P = .019) versus male patients. Conclusions: Compared with men, early female rejection is reduced and overall female survival is longer after alemtuzumab induction. However, intermediate-term female graft survival is less.