Reversal of acute cellular rejection after renal transplantation with Campath-1H.

Authors

• A Basu
• M Ramkumar
• H P Tan
• A Khan
• J McCauley
• A Marcos
• J J Fung
• T E Starzl
• R Shapiro

Publication/Presentation Date

3-1-2005

Abstract

Between September 2002 and February 2004, 40 kidney transplant (27 from deceased and 13 from living donors) recipients (25 male and 15 female, aged 50.3 +/- 15.1 years) were treated with Campath 1H (C 1H; 30 mg/dose IV) for biopsy-proven steroid-resistant rejection (SRR) or rejections equal to or worse than Banff 1B. All transplantations occurred between August 2001 and May 2003. All patients had received antibody preconditioning (RATG 5 mg/kg, n = 34; C 1H 60 mg, n = 4; C 1H 30 mg, n = 2) preoperatively and were treated with Tacrolimus monotherapy (target level 10 ng/ml) postoperatively and subsequent spaced weaning. Elevated creatinine levels at follow-up were evaluated by renal transplant biopsy. Rejection was treated with steroids, reversal of weaning, addition of sirolimus, and/or antibody treatment, depending on grade of rejection. The mean duration of follow-up was 453 +/- 163 days after C 1H administration. Twenty-nine patients received C 1H for SRR and 11 patients for Banff 1B or worse rejections; 26 patients received more than 1 dose of C 1H. Graft survival was 62.5% (25 patients); 6 of the 15 allografts (40%) that failed had presented with rejections because of noncompliance. Graft survival in compliant patients with SRR or rejections equal to or worse than Banff 1B was 73.5% (25 of 34). Fourteen patients (35%) had infectious complications, of whom 2 patients (5%) died. C 1H is an effective agent for SRR and Banff 1B or worse rejections, with 95% patient survival and 73.5% graft survival (in compliant patients). The number of doses of 30 mg C 1H should be restricted to two, as there is a high incidence of potentially fatal infectious complications.

Volume

37

Issue

2

First Page

923

Last Page

926

ISSN

0041-1345

Published In/Presented At

Basu, A., Ramkumar, M., Tan, H. P., Khan, A., McCauley, J., Marcos, A., Fung, J. J., Starzl, T. E., & Shapiro, R. (2005). Reversal of acute cellular rejection after renal transplantation with Campath-1H. Transplantation proceedings, 37(2), 923–926. https://doi.org/10.1016/j.transproceed.2004.12.019

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

15848576

Department(s)

Administration and Leadership

Document Type

Article