Comparison 4. Alemtuzumab + early steroid withdrawal (ESW) versus no induction.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Main outcomes	4		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
1.1 Death at 6 to 12 months	4	296	Risk Ratio (M‐H, Random, 95% CI)	1.54 [0.60, 4.00]
1.2 Graft loss (all cause) at 6 to 12 months	4	296	Risk Ratio (M‐H, Random, 95% CI)	0.86 [0.47, 1.59]
1.3 Acute rejection at 6 months	3	213	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.48, 1.08]
1.4 Acute rejection ≥ 1 year	3	244	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.42, 1.87]
1.5 Delayed graft function	1	30	Risk Ratio (M‐H, Random, 95% CI)	2.0 [0.26, 15.62]
2 Other adverse outcomes	3		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
2.1 CMV infection	2	161	Risk Ratio (M‐H, Random, 95% CI)	2.28 [1.18, 4.40]
2.2 Infection (all cause)	3	213	Risk Ratio (M‐H, Random, 95% CI)	1.15 [0.46, 2.89]
2.3 NODAT	2	161	Risk Ratio (M‐H, Random, 95% CI)	0.57 [0.13, 2.46]
2.4 Thrombocytopenia	1	30	Risk Ratio (M‐H, Random, 95% CI)	1.33 [0.45, 3.96]
2.5 Malignancy or PTLD	1	30	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Serum creatinine	3		Mean Difference (IV, Random, 95% CI)	Subtotals only
3.1 6 months	1	27	Mean Difference (IV, Random, 95% CI)	‐5.0 [‐28.90, 18.90]
3.2 1 year	2	108	Mean Difference (IV, Random, 95% CI)	‐2.89 [‐43.29, 37.52]