title: Use of non-irradiated blood components in Campath (alemtuzumab)-treated renal transplant patients.
abstract: BACKGROUND
  The prevention of transfusion-associated graft-versus-host disease (TA-GvHD) through the irradiation of components is key as there is no effective treatment. Universal leucodepletion reduces but may not eliminate TA-GvHD; therefore, irradiation is still recommended. In 2010, Campath (alemtuzumab) was added as an indication for irradiation but was not implemented everywhere.
  
  
  OBJECTIVE
  To identify any cases of TA-GvHD in our Campath-conditioned renal transplant patients, who were transfused with non-irradiated components.
  
  
  METHODS
  Retrospective study of Campath-conditioned renal transplant patients transfused with non-irradiated components. In those transfused up to 9 months following Campath who survived to 1-year follow-up, TA-GvHD was excluded. For patients not followed-up for a full year, we reviewed medical records for features of TA-GvHD. For patients transfused after 9 months following Campath, survival of at least 3 months following last transfusion excluded TA-GvHD.
  
  
  RESULTS
  Six hundred and forty-seven Campath-conditioned renal transplant patients were transfused; 616 were transfused within 9 months following Campath; 601 were alive at 1 year, excluding TA-GvHD. Twelve died and three were not followed-up for a full year, but a review of medical records excluded TA-GvHD. The 31 patients transfused 9 months or longer following Campath were all alive 6 months following the last transfusion, excluding TA-GvHD.
  
  
  CONCLUSIONS
  Despite receiving non-irradiated components, none of the 647 Campath-conditioned renal transplant patients developed TA-GvHD. Further reviews to replicate our data could enable change to guidance, at least in UK where components are leucodepleted, as an unnecessary requirement for irradiated components has both clinical delay and cost implications.
authors.affiliation: Department of Haematology, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Y M T
authors.initials: YM
authors.lastname: Hui
authors.affiliation: Department of Haematology, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: F
authors.initials: F
authors.lastname: Regan
authors.affiliation: Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Willecombe
authors.affiliation: Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Taube
mesh_terms: D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D016913:Blood Component Transfusion; D058731:Blood Safety; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000401:mortality / Q000628:therapy; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000074323:Alemtuzumab
keywords: Campath (alemtuzumab); Irradiated blood components; Transfusion associated graft versus host disease; Transplantation