Alemtuzumab (Campath-1H) combined with tacrolimus in intestinal and multivisceral transplantation

Andreas G. Tzakis, Tomoaki Kato, Seigo Nishida, David M. Levi, Panagiotis Tryphonopoulos, Juan R. Madariaga, Werviston De Faria, Jose R. Nery, Arie Regev, Rodrigo Vianna, Joshua Miller, Violet Esquenazi, Debbie Weppler, Phillip Ruiz

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91 Scopus citations

Abstract

Background. We combined alemtuzumab (Campath-1H, Berlex Laboratories, Montville, NJ) and tacrolimus (Tac) immunosuppression for intestinal and multivisceral transplantation. Materials and Methods. A total of 21 adult patients received 24 grafts: 14 intestinal, nine multivisceral, and one liver-intestinal graft. Alemtuzumab was ad. ministered perioperatively in four doses with low. dose Tac (levels 10-15 ng/dL) and no maintenance steroids. Tac was substituted with sirolimus in case of Tac-related complications. Suspected or mild rejections were treated with steroids. Moderate rejections were treated with steroids or OKT3. Severe rejections were treated with OKT3. Results. Of the 16 patients that were followed up for an average of 9 months, 12 are alive with functioning grafts. Two patients experienced severe rejection, three experienced moderate rejection episodes, and seven experienced mild acute rejection episodes. Four patients never developed acute rejection. Infectious complications included a cytomegalovirus enteritis and four fungal infections (related to central venous access). Conclusions. The combination of alemtuzumab and Tac therapy without steroid use seems to efficiently prevent acute rejection in a significant number of patients without causing frequent opportunistic infections.

Original languageEnglish (US)
Pages (from-to)1512-1517
Number of pages6
JournalTransplantation
Volume75
Issue number9
DOIs
StatePublished - May 15 2003

ASJC Scopus subject areas

  • Transplantation

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    Tzakis, A. G., Kato, T., Nishida, S., Levi, D. M., Tryphonopoulos, P., Madariaga, J. R., De Faria, W., Nery, J. R., Regev, A., Vianna, R., Miller, J., Esquenazi, V., Weppler, D., & Ruiz, P. (2003). Alemtuzumab (Campath-1H) combined with tacrolimus in intestinal and multivisceral transplantation. Transplantation, 75(9), 1512-1517. https://doi.org/10.1097/01.TP.0000060250.50591.39