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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 18, 2026; 16(1): 111959
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.111959
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.111959
Outcomes of basiliximab vs alemtuzumab induction in kidney allograft recipients with matched immunological Profiles: A retrospective cohort study
Chukwuma A Chukwu, Anirudh Rao, Department of Nephrology, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8YE, Mersey Side, United Kingdom
Philip A Kalra, Department of Nephrology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester M6 8HD, Greater Manchester, United Kingdom
Philip A Kalra, Faculty of Biology, Medicine and Health, Department of Cardiovascular Medi
Marcus Lowe, Kay Poulton, Department of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester M13 9PL, Greater Manchester, United Kingdom
Marcus Lowe, Kay Poulton, Transplantation Laboratory, Manchester Royal Infirmary, Man
Titus Augustine, Department of Renal and Pancreatic Transplantation, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9PL, Greater Manchester, United Kingdom
Titus Augustine, Department of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester M13 9PL, Greater Manchester, United Kingdom
Author contributions: Chukwu CA performed analysis and interpretation of data and drafted the initial manuscript; Chukwu CA, Lowe M, Poulton K, Augustine T, and Rao A contributed to acquisition of data; Chukwu CA, Kalra PA, Augustine T, and Rao A contributed to critical revision of manuscript for intellectual content; Chukwu CA, Augustine T, and Rao A initiated study concepts and design; Kalra PA and Augustine T provided administrative support and overall study supervision; all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by and registered with the Northern Care Alliance Research and Innovation Department in the United Kingdom, No. S21HIP03.
Informed consent statement: This study was conducted using routinely collected clinical data that had been fully anonymised prior to analysis. As such, no identifiable patient information was used. The study was reviewed and approved by the appropriate institutional review board, which determined that written informed consent was not required in accordance with local regulations and ethical guidelines.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: The dataset supporting the findings of this study has been deposited in Mendeley Data and is publicly available at: 10.17632/3vdszzmz2n.1.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chukwuma A Chukwu, PhD, Consultant, Department of Nephrology, Liverpool University Hospitals NHS Foundation Trust, Mount Vernon Street, Liverpool L7 8YE, Mersey Side, United Kingdom. chukwuma.chukwu@rlbuht.nhs.uk
Received: July 15, 2025
Revised: October 9, 2025
Accepted: December 9, 2025
Published online: March 18, 2026
Processing time: 184 Days and 7.4 Hours
Revised: October 9, 2025
Accepted: December 9, 2025
Published online: March 18, 2026
Processing time: 184 Days and 7.4 Hours
Core Tip
Core Tip: This retrospective cohort study compared real-world outcomes of alemtuzumab and basiliximab induction in kidney transplant recipients from two tertiary centers in North-West England, one routinely using alemtuzumab and the other exclusively basiliximab. Using propensity score matching to reduce confounding, we evaluated graft function, graft and patient survival, acute rejection, infection, and other long-term complications. Alemtuzumab induction was found to be associated with lower estimated glomerular filtration rate, and higher risks of cytomegalovirus and BK viremia, post-transplant malignancy, and death-censored graft loss compared with basiliximab. These findings emphasize the need for individualized selection of induction therapy, balancing the potent immunosuppressive effects of alemtuzumab against its potential for adverse outcomes, and support tailored approaches based on recipient risk profile and center-specific experience.