| Alemtuzumab induction in deceased donor kidney transplantation. | |
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MedLine Citation:
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PMID: 21839271 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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M Shin; S H Song; J M Kim; C H Kwon; J W Joh; S-K Lee; S-J Kim |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Transplantation proceedings Volume: 43 ISSN: 1873-2623 ISO Abbreviation: Transplant. Proc. Publication Date: 2011 Jul-Aug |
Date Detail:
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Created Date: 2011-08-15 Completed Date: 2012-01-05 Revised Date: 2013-05-27 |
Medline Journal Info:
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Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
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Languages: eng Pagination: 2365-78 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Surgery, Division of Transplant Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Antibodies, Monoclonal, Humanized; 0/Antibodies, Neoplasm; 0/HLA Antigens; 0/Immunosuppressive Agents; 3A189DH42V/alemtuzumab; EC 3.1.3.16/Calcineurin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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