Campath-1H immunosuppressive therapy reduces incidence and intensity of acute rejection in intestinal and multivisceral transplantation

Short bowel and long life: No longer mutually exclusive

“…7 Preliminary findings have reported 2-year survival up to 100%, as well as full intestinal autonomy within days of transplantation using this regimen. 6,7 The principle governing recipient preconditioning is recipient lymphocyte and/or monocyte ablation immediately before the transplant. 7 A polyclonal T-cell or monocyte antibody is given to the recipient just before allograft reperfusion.…”

“…6,7 The principle governing recipient preconditioning is recipient lymphocyte and/or monocyte ablation immediately before the transplant. 7 A polyclonal T-cell or monocyte antibody is given to the recipient just before allograft reperfusion. This strategy has produced better short-term allograft acceptance, a decreased need for immunosuppression, and fewer opportunistic infections for recipients receiving transplants in these medical centers.…”

“…This strategy has produced better short-term allograft acceptance, a decreased need for immunosuppression, and fewer opportunistic infections for recipients receiving transplants in these medical centers. 6,7 Ultimately, the paper by Quiros-Tejeira et al teaches us that long life is indeed possible for infants with SBS. 5 These infants, when managed in a center of excellence with an active home TPN program, have a strong likelihood of survival.…”

Small intestine transplantation today

“…Most recently, the depleting anti-CD52 antibody alemtuzumab was investigated after ITx. Alemtuzumab decreased the mean grade of acute rejection more than daclizumab [75]. Noteworthy, Campath-treated recipients increased lyphoplasmacytic hyperplasia, which is potentially a pre-lyphomatous lesion [76].…”

The response of intestinal stem cells and epithelium after alemtuzumab administration

“…9 Alemtuzemab (Campath-1H; ILEX, San Antonio, TX, USA), a humanized anti-CD52 antibody, has been used therapeutically with increasing frequency for immunosuppressive induction in solid organ transplantation. [10][11][12] Moreover, alemtuzumab has been used for lymphodepletion in hematopoietic stem cell transplantation and for the treatment of chronic lymphocytic leukemia and multiple sclerosis. The use of alemtuzumab has changed the spectrum of infections in transplant patients, and it does not render patients more susceptible to viral or bacterial infections compared to conventional triple immunosuppression.…”