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Campath-1H in renal transplantation: The University of Wisconsin experience

2004; Elsevier BV; Volume: 136; Issue: 4 Linguagem: Inglês

10.1016/j.surg.2004.06.015

1532-7361

Stuart J. Knechtle, Luis A. Fernandez, John D. Pirsch, Bryan N. Becker, L. Thomas Chin, Yolanda T. Becker, Jon S. Odorico, Anthony M. D’Alessandro, Hans W. Sollinger,

Renal Diseases and Glomerulopathies

Background Immune cell depletion is known to prevent renal allograft rejection and injury. We evaluated the humanized monoclonal antibody Campath-1H (alemtuzumab; ILEX Oncology, San Antonio, Texas) in renal transplant recipients for its safety and efficacy in preventing rejection when used in combination with a calcineurin inhibitor, mycophenolate mofetil, and low-dose steroid therapy. Methods One hundred twenty-six consecutive renal allograft recipients received 2 doses of Campath-1H antibody on days 0 and 1. Outcomes were compared to patients who received an anti-CD25 antibody (n = 799), Thymoglobulin (n = 160), or other antibody treatment (n = 156) in combination with a calcineurin inhibitor, mycophenolate mofetil, and higher dose steroids. Results The Campath-1H group overall experienced less rejection than the other 3 groups (P = .037). Patients with delayed graft function experienced less rejection with Campath-1H than control groups (P = .0096) and improved graft survival (P = .0119). There was no difference in infection or malignancies between the 4 groups. Conclusions Campath-1H was well tolerated in renal transplant patients and led to significant reductions in incidence of rejection. Patients with delayed graft function experienced significantly improved graft survival. Immune cell depletion is known to prevent renal allograft rejection and injury. We evaluated the humanized monoclonal antibody Campath-1H (alemtuzumab; ILEX Oncology, San Antonio, Texas) in renal transplant recipients for its safety and efficacy in preventing rejection when used in combination with a calcineurin inhibitor, mycophenolate mofetil, and low-dose steroid therapy. One hundred twenty-six consecutive renal allograft recipients received 2 doses of Campath-1H antibody on days 0 and 1. Outcomes were compared to patients who received an anti-CD25 antibody (n = 799), Thymoglobulin (n = 160), or other antibody treatment (n = 156) in combination with a calcineurin inhibitor, mycophenolate mofetil, and higher dose steroids. The Campath-1H group overall experienced less rejection than the other 3 groups (P = .037). Patients with delayed graft function experienced less rejection with Campath-1H than control groups (P = .0096) and improved graft survival (P = .0119). There was no difference in infection or malignancies between the 4 groups. Campath-1H was well tolerated in renal transplant patients and led to significant reductions in incidence of rejection. Patients with delayed graft function experienced significantly improved graft survival.