Document Detail


Alemtuzumab induction in deceased donor kidney transplantation.
MedLine Citation:
PMID:  21839271     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Alemtuzumab (Campath-1H), a humanized monoclonal antibody directed against CD52, is a lymphocyte-depleting agent currently being evaluated as an induction agent in solid organ transplantation. This study analyzed the clinical outcomes and effects on peripheral blood lymphocyte subset counts in adult deceased donor renal transplant recipients who received an alemtuzumab-based induction protocol.
METHODS: Eleven kidney alone or simultaneous pancreas-kidney transplant recipients received 20 mg alemtuzumab on postoperative days 0 and 1, followed by calcineurin inhibitor-based maintenance immunosuppression after postoperative day 5. We collected 1-year data including recipient and donor demographic features, renal function and adverse events including endocrine impact, incidence of acute rejection episodes, infections or malignancies as well as hematologic and late immunologic parameters for correlation with patient or graft survival.
RESULTS: Mean HLA mismatch was 3.6 and 8/11 deceased donors were of the extended criteria type. Only 2 (18%) recipients displayed delayed graft function with a failure of the serum creatinine to decrease by 25% on the first day; however, their long-term outcomes were similar to other nonaffected patients. Serious adverse events were absent; there was no hyperlipidemia or new-onset diabetes. We failed to observe an acute rejection. The 3 (27%) recipients with infectious complications experienced pericardial tuberculosis, urinary tract infection, or invasive pulmonary aspergillosis. Two (18%) cases of posttransplantation lymphoproliferative disease were diagnosed in this study during the follow-up. Overall patient and graft survival rates were both 91%.
CONCLUSION: This study demonstrated that preconditioning with antibody-depletion using alemtuzumab was efficient with satisfactory patient and graft survivals at 1 year. Alemtuzumab induction was safe even for recipients of extended criteria donor renal transplantation.
Authors:
M Shin; S H Song; J M Kim; C H Kwon; J W Joh; S-K Lee; S-J Kim
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  43     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:    2011 Jul-Aug
Date Detail:
Created Date:  2011-08-15     Completed Date:  2012-01-05     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2365-78     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, Division of Transplant Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal, Humanized / therapeutic use*
Antibodies, Neoplasm / therapeutic use*
Calcineurin / antagonists & inhibitors
Communicable Diseases / etiology
Delayed Graft Function / etiology
Drug Therapy, Combination
Female
Graft Rejection / etiology,  prevention & control
Graft Survival
HLA Antigens / immunology
Histocompatibility
Humans
Immunosuppressive Agents / therapeutic use*
Kidney Transplantation* / adverse effects,  immunology
Lymphoproliferative Disorders / etiology
Male
Middle Aged
Pancreas Transplantation
Prospective Studies
Republic of Korea
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 0/Antibodies, Neoplasm; 0/HLA Antigens; 0/Immunosuppressive Agents; 3A189DH42V/alemtuzumab; EC 3.1.3.16/Calcineurin

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