Intestinal transplantation with alemtuzumab (Campath-1H) induction for adult patients.
BACKGROUND
Alemtuzumab (Campath-1H [C1H]) is a humanized monoclonal antibody directed against the CD 52 antigen that is present on the surface of T cells, B cells, natural killer cells and monocytes. We studied its application in intestinal transplantation.


METHODS
This is a retrospective review of adult patients who underwent intestinal transplantation between December 1994 and May 2005. Group 1: non-C1H group (n = 39); group 2: C1H group (n = 37). C1H was administered as an induction immunosuppression in four doses (0.3 mg/kg), or in two doses (30 mg/kg). Tacrolimus levels were maintained at low level (5-10 ng/dL). No maintenance steroids were given.


RESULTS
One-year survival of group 1 and group 2 patients were 57% and 70%, respectively. This difference is not statistically significant. Of 37 patients in group 2, 21 are alive. The incidence of rejection was lower in group 2 (P < .005). Average current tacrolimus level is 6.97 +/- 3.98 ng/dL. Seventeen patients (81%) are steroid free, and 15 (71%) are maintained solely on tacrolimus. There was no graft versus host disease in group 2.


CONCLUSIONS
Our preliminary data suggest that C1H can provide effective immunosuppression for intestinal transplantation. Incidence of rejection was less with this regimen using low maintenance tacrolimus and minimal steroids.
Nishida
S
S
Division of Transplantation, Department of Surgery, University of Miami/Jackson Memorial Medical Center, Highland Professional Building, 1801 NW 9th Avenue, Miami, FL 33136, USA.
Levi
D M
DM
Moon
J I
JI
Madariaga
J R
JR
Kato
T
T
Selvaggi
G
G
Tryphonopoulos
P
P
DeFaria
W
W
Santiago
S
S
Gaynor
J
J
Weppler
D
D
Martinez
E
E
Ruiz
P
P
Tzakis
A G
AG
D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007422:Intestines / Q000637:transplantation*; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013997:Time Factors; D014184:Transplantation, Homologous / Q000276:immunology* / Q000401:mortality
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab