The use of Campath-1H as induction therapy in renal transplantation

Preliminary results

Gaetano Ciancio, George W Burke, Jeffrey Gaynor, Adela D Mattiazzi, Ramin Roohipour, Manuel R. Carreno, David Roth, Phillip Ruiz, Warren Kupin, Anne Rosen, Violet Esquenazi, Andreas G. Tzakis, Joshua Miller

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

Background. In an attempt to reduce both initial and long-term (nephrotoxic) calcineurin inhibitor maintenance dosage and totally eliminate maintenance corticosteroids, alemtuzumab (Campath-1H) was used as induction therapy in first cadaver and non-HLA-identical living donor renal transplantation. Methods. Forty-four de novo renal allograft recipients were treated with Campath-1H (0.3 mg/kg) on days 0 and 4 postoperatively, preceded by methylprednisolone boluses. Maintenance target 12-hr tacrolimus trough levels of 5 to 7 ng/mL were operational from the outset as well as (reduced) mycophenolate mofetil dosage of 500 mg twice daily. No corticosteroids were planned to be given after the first week postoperatively. Results. With a median follow-up of 9 (range, 1-19) months, patient and graft survival rates are each at 100%. Biopsy-proven acute rejection was diagnosed in four patients. Infections requiring hospitalization developed in four patients. Thirty-eight recipients remain without the need for long-term corticosteroid therapy. Conclusions. In an early assessment, the combination of Campath-1H, low dosing of tacrolimus and mycophenolate mofetil, and avoidance of maintenance corticosteroid use seems to be safe and effective for kidney transplant recipients. Long-term outcomes will be reported in the future.

Original languageEnglish
Pages (from-to)426-433
Number of pages8
JournalTransplantation
Volume78
Issue number3
DOIs
StatePublished - Aug 15 2004

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Kidney Transplantation
Adrenal Cortex Hormones
Maintenance
Mycophenolic Acid
Tacrolimus
Kidney
Living Donors
Methylprednisolone
Graft Survival
Therapeutics
Cadaver
Allografts
Hospitalization
Survival Rate
Biopsy
alemtuzumab
Infection

Keywords

  • Acute rejection
  • Campath-1H
  • Induction therapy
  • Mycophenolate mofetil
  • Renal allograft
  • Tacrolimus

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

The use of Campath-1H as induction therapy in renal transplantation : Preliminary results. / Ciancio, Gaetano; Burke, George W; Gaynor, Jeffrey; Mattiazzi, Adela D; Roohipour, Ramin; Carreno, Manuel R.; Roth, David; Ruiz, Phillip; Kupin, Warren; Rosen, Anne; Esquenazi, Violet; Tzakis, Andreas G.; Miller, Joshua.

In: Transplantation, Vol. 78, No. 3, 15.08.2004, p. 426-433.

Research output: Contribution to journalArticle

Ciancio, Gaetano ; Burke, George W ; Gaynor, Jeffrey ; Mattiazzi, Adela D ; Roohipour, Ramin ; Carreno, Manuel R. ; Roth, David ; Ruiz, Phillip ; Kupin, Warren ; Rosen, Anne ; Esquenazi, Violet ; Tzakis, Andreas G. ; Miller, Joshua. / The use of Campath-1H as induction therapy in renal transplantation : Preliminary results. In: Transplantation. 2004 ; Vol. 78, No. 3. pp. 426-433.
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AU - Burke, George W

AU - Gaynor, Jeffrey

AU - Mattiazzi, Adela D

AU - Roohipour, Ramin

AU - Carreno, Manuel R.

AU - Roth, David

AU - Ruiz, Phillip

AU - Kupin, Warren

AU - Rosen, Anne

AU - Esquenazi, Violet

AU - Tzakis, Andreas G.

AU - Miller, Joshua

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AB - Background. In an attempt to reduce both initial and long-term (nephrotoxic) calcineurin inhibitor maintenance dosage and totally eliminate maintenance corticosteroids, alemtuzumab (Campath-1H) was used as induction therapy in first cadaver and non-HLA-identical living donor renal transplantation. Methods. Forty-four de novo renal allograft recipients were treated with Campath-1H (0.3 mg/kg) on days 0 and 4 postoperatively, preceded by methylprednisolone boluses. Maintenance target 12-hr tacrolimus trough levels of 5 to 7 ng/mL were operational from the outset as well as (reduced) mycophenolate mofetil dosage of 500 mg twice daily. No corticosteroids were planned to be given after the first week postoperatively. Results. With a median follow-up of 9 (range, 1-19) months, patient and graft survival rates are each at 100%. Biopsy-proven acute rejection was diagnosed in four patients. Infections requiring hospitalization developed in four patients. Thirty-eight recipients remain without the need for long-term corticosteroid therapy. Conclusions. In an early assessment, the combination of Campath-1H, low dosing of tacrolimus and mycophenolate mofetil, and avoidance of maintenance corticosteroid use seems to be safe and effective for kidney transplant recipients. Long-term outcomes will be reported in the future.

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