Campath induction for kidney transplantation: report of 297 cases.
OBJECTIVE
To evaluate 297 adult renal transplantation patients who received Campath-1H-based induction protocol.


METHODS
Single center Institutional Review Board approved retrospective chart review of 297 patients who received alemtuzumab induction between November 2003 and December 2005. Maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil, and rapidly tapered solumedrol with few exceptional cases. The mean patient follow-up was 362 days. All rejection episodes were biopsy confirmed. Posttransplant infection rates were recorded.


RESULTS
There were 153 living donor and 144 deceased donor recipients. One-year survival rates for recipient and kidney allografts were 100% and 98% for living donors, 97.4% and 89.7% for non-extended criteria donors (ECD) deceased donors, and 85.7% and 89.3% for ECD deceased donors. The overall rejection rate was 7%. Overall infectious rate was 19.8%. We had no cases of posttransplant lymphoproliferative disease. Of the 289 recipients discharged off prednisone, 269 (93%) remain steroid free.


CONCLUSIONS
Alemtuzumab and reduced dosages of tacrolimus and mycophenolate without long-term steroids can achieve low rates of rejection and excellent graft and patient survival without excessive risk of infection or malignancy. There is still a need for large randomized trials with long-term follow-up to determine its exact role in solid organ transplantation.
Methodist specialty and Transplant Hospital, Texas Transplant Institute, San Antonio, TX 78229, USA.
Jorge
J
Ortiz
Juan
J
Palma-Vargas
Francis
F
Wright
Adam
A
Bingaman
Irfan
I
Agha
Steven
S
Rosenblatt
Preston
P
Foster
D000293:Adolescent; D000328:Adult; D000368:Aged; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001706:Biopsy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007275:Injections, Intravenous; D007430:Intraoperative Care / Q000379:methods; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab