Outcomes at 3 years of a prospective pilot study of Campath-1H and sirolimus immunosuppression for renal transplantation |
| |
Authors: | Rolf N Barth Christina A Janus Christine A Lillesand Nancy A Radke John D Pirsch Bryan N Becker Luis A Fernandez L Thomas Chin Yolanda T Becker Jon S Odorico Anthony M D'Alessandro Hans W Sollinger Stuart J Knechtle |
| |
Institution: | Department of Surgery, Division of Transplantation, University of Wisconsin School of Medicine and Public Health, Madison, 53792-7375, USA. |
| |
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. |
| |
Keywords: | immunosuppression kidney transplant sirolimus Campath-1H |
|
|