title: Alemtuzumab (Campath-1H) therapy for refractory rejections in pediatric heart transplant recipients.
abstract: Despite substantial improvements in survival after pediatric heart transplantation, refractory rejection remains a major cause of morbidity and mortality. We have utilized ALE (Campath-1H) in six consecutive patients with refractory rejection. These rejection episodes persisted despite conventional treatment, which included intravenous methylprednisolone, rituximab, immunoglobulin G, and antithymocyte globulin. In our series, after ALE therapy, LV SF increased from 22%±5% to 33%±5% (P=.01). However, in our series, ALE therapy neither led to persistent LV function recovery nor could it prevent subsequent antibody-mediated rejection.
authors.affiliation: Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Bibhuti
authors.initials: B
authors.lastname: Das
authors.affiliation: Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Dimas
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, Department of Cardiothoracic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Guleserian
authors.affiliation: Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Chantale
authors.initials: C
authors.lastname: Lacelle
authors.affiliation: Children's Medical Center, Dallas, TX, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Anton
authors.affiliation: Children's Medical Center, Dallas, TX, USA.
authors.forename: Lindy
authors.initials: L
authors.lastname: Moore
authors.affiliation: Children's Medical Center, Dallas, TX, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Morrow
mesh_terms: D000293:Adolescent; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D000077552:Basiliximab; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D016027:Heart Transplantation; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D009173:Mycophenolic Acid / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage; D016559:Tacrolimus / Q000008:administration & dosage; D066027:Transplant Recipients
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000961:Antilymphocyte Serum; D007074:Immunoglobulin G; D011993:Recombinant Fusion Proteins; D000074323:Alemtuzumab; D000069283:Rituximab; D000077552:Basiliximab; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus; D008775:Methylprednisolone
keywords: alemtuzumab (Campath-1H); pediatric heart transplant; refractory acute rejections