Preliminary Experience With Alemtuzumab (Campath-1h) and Low-Dose Tacrolimus Immunosuppression in Adult Liver Transplantation

Tzakis, Andreas G.; Tryphonopoulos, Panagiotis; Kato, Tomoaki; Nishida, Seigo; Levi, David; Madariaga, Juan; Gaynor, Jeffrey J.; Faria, Werviston De; Regev, Arie; Esquenazi, Violet; Weppler, D.; Ruiz, Phillip; Miller, Joshua

doi:10.1097/01.tp.0000116562.15920.43

Cited by 108 publications

(59 citation statements)

References 14 publications

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“…More recently alemtuzumab has been used increasingly in the United State as an induction agent for kidney, pancreas, lung and liver transplantation, again with promising short-term results (18)(19)(20). To date there has been no prospective, randomized controlled trial of alemtuzumab in transplantation.…”

Section: Introductionmentioning

confidence: 99%

Alemtuzumab (CAMPATH 1H) Induction Therapy in Cadaveric Kidney Transplantation―Efficacy and Safety at Five Years

Watson

Bradley

Friend

et al. 2005

American Journal of Transplantation

216

112

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Alemtuzumab is a powerful lymphocyte depleting antibody currently being evaluated in solid organ transplantation. This paper describes 5-year results of a single center study of alemtuzumab as induction in renal transplantation.Thirty-three renal transplant recipients received 20mg alemtuzumab on day 0 and 1, followed by half-dose cyclosporin monotherapy (trough concentration 75-125 ng/mL) from day 3. They were compared in a retrospective contemporaneous-controlled manner with 66 kidney transplant recipients transplanted in the same period and center who received conventional immunosuppression with cyclosporin, azathioprine and prednisolone. In the alemtuzumab group 12% of recipients died compared to 17% in the control group (p = 0.48); likewise graft loss was similar in both groups (21% vs. 26%, respectively, p = 0.58). Incidence of acute rejection was also comparable at 5 years (31.5% vs. 33.6%), although the pattern of rejection was different with 14% patients in the alemtuzumab group experiencing rejection over 1 year post-transplant compared to none in the control group. There was no significant difference between groups in terms of infection or serious adverse events.While acknowledging the limitations of a relatively small single-center study, results suggest that alemtuzumab induction allowed satisfactory long-term patient and graft survival equivalent to that seen with standard triple immunosuppression, while avoiding steroid therapy.

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Section: Introductionmentioning

confidence: 99%

Alemtuzumab (CAMPATH 1H) Induction Therapy in Cadaveric Kidney Transplantation―Efficacy and Safety at Five Years

Watson

Bradley

Friend

et al. 2005

American Journal of Transplantation

216

112

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“…Several studies in renal transplant patients have shown its efficacy in preventing rejection when used in combination with low-dose CNIs or sirolimus [99101] . Tzakis et al [102] compared the use of alemtuzumab induction therapy combined with lowdose tacrolimus in liver transplant recipients receiving standard doses of tacrolimus and corticosteroids. Although patients who received alemtuzumab had less renal dysfunction and acute rejection in the first two months post-transplant, the overall incidence of rejection was not significantly different between the two groups.…”

Section: Monoclonal Antibodiesmentioning

confidence: 99%

Overview of immunosuppression in liver transplantation

Pillai¹,

Levitsky²

2009

WJG

105

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Continued advances in surgical techniques and immunosuppressive therapy have allowed liver transplantation to become an extremely successful treatment option for patients with end-stage liver disease. Beginning with the revolutionary discovery of cyclosporine in the 1970s, immunosuppressive regimens have evolved greatly and current statistics confirm one-year graft survival rates in excess of 80%. Immunosuppressive regimens include calcineurin inhibitors, anti-metabolites, mTOR inhibitors, steroids and antibody-based therapies. These agents target different sites in the T cell activation cascade, usually by inhibiting T cell activation or via T cell depletion. They are used as induction therapy in the immediate periand post-operative period, as long-term maintenance medications to preserve graft function and as salvage therapy for acute rejection in liver transplant recipients. This review will focus on existing immunosuppressive agents for liver transplantation and consider newer medications on the horizon.

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“…Parece, por tanto, que con esta pauta se podrían mantener los injertos con bajas dosis de inmunodepresión, con pocos efectos secundarios y a un coste bajo. La experiencia en el TH ha sido publicada recientemente por Tzakis et al 63 y Marcos et al 64 .…”

Section: Nuevas Pautas De Inmunodepresión Inductoras De Toleranciaunclassified

Inmunodepresión en el período postoperatorio inmediato del trasplante hepático

Pons

Ramírez

Robles

et al. 2004

Gastroenterol Hepatol

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Preliminary Experience With Alemtuzumab (Campath-1h) and Low-Dose Tacrolimus Immunosuppression in Adult Liver Transplantation

Abstract: C1H and low-dose Tac seems to be at least as effective as our standard Tac and steroids regimen in preventing acute rejection in adult liver allotransplantation with less renal toxicity and less use of maintenance steroids.

Cited by 108 publications

References 14 publications

Alemtuzumab (CAMPATH 1H) Induction Therapy in Cadaveric Kidney Transplantation―Efficacy and Safety at Five Years

Alemtuzumab (CAMPATH 1H) Induction Therapy in Cadaveric Kidney Transplantation―Efficacy and Safety at Five Years

Overview of immunosuppression in liver transplantation

Inmunodepresión en el período postoperatorio inmediato del trasplante hepático

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