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- Title
Outcomes at 3 years of a prospective pilot study of Campath-1H and sirolimus immunosuppression for renal transplantation.
- Authors
Barth, Rolf N.; Janus, Christina A.; Lillesand, Christine A.; Radke, Nancy A.; Pirsch, John D.; Becker, Bryan N.; Fernandez, Luis A.; Chin, L. Thomas; Becker, Yolanda T.; Odorico, Jon S.; D'Alessandro, Anthony M.; Sollinger, Hans W.; Knechtle, Stuart J.
- Abstract
Campath-1H (alemtuzumab) induction was used for renal transplantation in combination with sirolimus as immunosuppression. We previously reported a high (28%) rate of early rejection with this regimen, and now report 3-year outcomes. Twenty-nine patients were recipients of either deceased donor or non-HLA (Human Leukocyte Antigen) identical living donor primary renal allografts. Clinical parameters including infection, malignancy, kidney function, and kidney histology were followed prospectively for 3 years. Three-year cumulative graft and patient survival were 96% and 100%, respectively. Twenty patients were maintained on steroid-free immunosuppressive regimens, and 15 patients were maintained on monotherapy for immunosuppression (12 on sirolimus). No serious infectious complications were observed and two patients developed basal cell skin cancer. The 3-year results of our initial pilot study demonstrate good graft (96%) and patient (100%) outcomes. Campath-1H induction has yielded a high proportion of patients maintained on immunosuppressive monotherapy (57%) without serious infectious- and no malignancy-related complications. The reported regimen yielded novel insights into both Campath-1H and sirolimus therapy in renal transplantation. Because of the higher incidence of early rejection, we recommend a modified strategy of immunosuppression including a brief course of a calcineurin inhibitor. (ClinicalTrials.gov number: NCT00365846, date: 16 August 2006)
- Subjects
KIDNEY transplantation; IMMUNOSUPPRESSION; RAPAMYCIN; HLA histocompatibility antigens; HOMOGRAFTS
- Publication
Transplant International, 2006, Vol 19, Issue 11, p885
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/j.1432-2277.2006.00388.x