Alemtuzumab (Campath 1H) Induction With Tacrolimus Monotherapy Is Safe for High Immunological Risk Renal Transplantation
- 15 June 2007
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 83 (11), 1509-1512
- https://doi.org/10.1097/01.tp.0000263344.53000.a1
Abstract
Immunosuppression for immunologically high-risk renal transplant patients usually involves antithymocyte globulin induction with triple drug maintenance therapy. Alemtuzumab, a humanized anti-CD52 antibody, has shown promise in tolerogenic induction protocols, requiring minimal maintenance immunosuppression. In this prospective, open-label, randomized, controlled trial, we enrolled 21 high immunological risk patients (i.e., panel reactive antibody>20% or previous transplant). Patients received either single-dose alemtuzumab given before graft reperfusion, with tacrolimus monotherapy, or four doses of Thymoglobulin with tacrolimus, mycophenolate, and steroids. Median follow-up was 377 days. One patient in the Thymoglobulin group who suffered primary graft nonfunction died. One-year cumulative graft survival was 85.7% for the alemtuzumab group and 87.5% for the Thymoglobulin group. Two alemtuzumab and three Thymoglobulin patients suffered rejection episodes. Infection rates were similar. Early results of this ongoing study indicate that a tolerogenic protocol with alemtuzumab induction and tacrolimus maintenance monotherapy is safe in immunologically high-risk renal transplant patients.Keywords
This publication has 19 references indexed in Scilit:
- Rabbit Antithymocyte Globulin versus Basiliximab in Renal TransplantationNew England Journal of Medicine, 2006
- The evolving role of alemtuzumab (Campath-1H) for immunosuppressive therapy in organ transplantationTransplant International, 2006
- Transplanting the Highly Sensitized Patient: The Emory AlgorithmAmerican Journal of Transplantation, 2006
- Alemtuzumab (Campath-1H): A Systematic Review in Organ TransplantationTransplantation, 2006
- A Randomized Trial of Three Renal Transplant Induction Antibodies: Early Comparison of Tacrolimus, Mycophenolate Mofetil, and Steroid Dosing, and Newer Immune-Monitoring1Transplantation, 2005
- Kidney transplantation under minimal immunosuppression after pretransplant lymphoid depletion with Thymoglobulin or CampathJournal of the American College of Surgeons, 2005
- Differential effects of interleukin-2 blockade on apoptosis in naïve and activated human lymphocytes1 2Transplantation, 2003
- CLINICAL AND SUBCLINICAL ACUTE REJECTION EARLY AFTER LIVER TRANSPLANTATIONTransplantation, 2001
- Blocking both signal 1 and signal 2 of T-cell activation prevents apoptosis of alloreactive T cells and induction of peripheral allograft toleranceNature Medicine, 1999
- CYCLOSPORINE STIMULATES EXPRESSION OF TRANSFORMING GROWTH FACTOR-β IN RENAL CELLS POSSIBLE MECHANISM OF CYCLOSPORINES ANTIPROLIFERATIVE EFFECTSTransplantation, 1995