Campath-1H as rescue therapy for the treatment of acute rejection in kidney transplant patients.
BACKGROUND
Kidney transplant patients with acute rejection episodes refractory to antilymphocyte preparations require aggressive treatment to salvage renal function and reduce the progression of chronic allograft nephropathy.


METHODS
During a 6-month period, we administered Campath-1H as salvage therapy to five patients who had been previously treated with thymoglobulin and/or OKT3. In addition to measurements of the serum creatinine and BUN levels, we estimated creatinine clearance and glomerular filtration rates (GFR) using the Cockcroft-Gault and the MDRD equations at the time of initiation of therapy as well as at 2 weeks and 2 months thereafter.


RESULTS
Four of the five patients responded to Campath-1H therapy; kidney function improved to nearly the level before the rejection episode. The estimated creatinine clearance increased approximately threefold and the GFR approximately fourfold higher than the values before Campath-1H administration. The adverse events were mild and self-limited.


CONCLUSIONS
Salvage of refractory acute rejection episodes may be possible in selected patients using Campath-1H.
Csapo
Z
Z
Division of Immunology and Organ Transplantation. The University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA.
Benavides-Viveros
C
C
Podder
H
H
Pollard
V
V
Kahan
B D
BD
D000208:Acute Disease; D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab