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In the control group, 10 acute rejections of the allografts were clinically suspected and 13 had a BPAR (4 Banff I and 9 Banff II rejections). Banff score was determined according to the Banff 07 classification of renal allograft pathology, published in the American Journal of Transplantation 2008 [19]. Fourteen rejections occurred in the DGF group and 9 in the non-DGF group. All of them could be treated successfully with steroids and an increase of maintenance immunosuppressive therapy. Acute rejection did not show any correlation with CMV status. 3.3. Patient and Graft Survival Five- and ten-year graft survival differed between the alemtuzumab (81.94% and 80.36%) and basiliximab group (78.52% and 52.66%) but without reaching significance, p = 0.076, Figure 1. The patient survival in the alemtuzumab group was significantly better five and ten years after KTx compared to the basiliximab group, 92.16% and 90.43% versus 83.77% and 62.25%, p = 0.001, Figure 2. Figure 1 Graft survival after 1, 5, and 10 years was 90.16%, 81.94%, and 80.36% in the alemtuzumab group versus 89.52%, 78.52%, and 52.66% for KTx recipients who received basiliximab; p = 0.076. Figure 2 Patient survival after 1, 5, and 10 years was 95.85%, 92.16%, and 90.43% in the alemtuzumab group versus 92.67%, 83.77%, and 62.25% for KTx recipients who received basiliximab; p = 0.001. Furthermore, a lymphocyte count below 2.5% during the first three weeks after KTx resulted in a lower graft and patient survival, independently from the induction agent. Sitaxentan five-year graft survival was 79.74% versus 86.21% in the recipient group with a lymphocyte count above 2.5%, p = 0.262. The five-year patient survival reached also a higher percentage in the recipient group with more than 2.5% lymphocytes, 91.01% versus 94.83%, p = 0.239. 3.4. Discussion Alemtuzumab is a powerful pan-lymphocyte-depleting induction agent [12]. The regeneration of blood lymphocytes and their subpopulations after treatment with alemtuzumab has been described in patients treated for rheumatoid arthritis [16, 20]. In kidney transplantation, alemtuzumab has been primarily used with the aim of reducing maintenance immunosuppression and reducing acute rejection and delayed graft function [2, 11, 21, 22]. Currently, approximately 80% of all kidney transplant patients in the United States receive an antibody induction therapy at the time of transplantation [1, 23, 24]. Lymphocyte depletion for induction has three conceptual possible benefits: inhibition of ischemia reperfusion injury, reduction of consecutive maintenance immunosuppression, and an overall more tolerogenic lymphocyte phenotype after recovery (this remains hypothetical). Several clinical studies have demonstrated that transient T-cell depletion can be combined with steroid-free maintenance immunosuppression with good results.