Campath-1H Induction and the Incidence of Infectious Complications in Adult Renal Transplantation

Malek, Sayeed K.; Obmann, Melissa; Gotoff, Robert; Foltzer, Michael; Hartle, James E.; Potdar, Santosh

doi:10.1097/01.tp.0000189713.14993.db

Cited by 58 publications

(34 citation statements)

References 11 publications

(10 reference statements)

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“…We have planned to investigate in future studies whether alemtuzumab, combined with an early lower-dose IS regimen, promotes tolerance (13,19) or preserves regulatory T cell function and thereby might provide an advantage that persists in the setting of standard long-term maintenance IS.…”

Section: Discussionmentioning

confidence: 99%

Alemtuzumab in Lung Transplantation: An Open-Label, Randomized, Prospective Single Center Study

Jaksch

Ankersmit

Scheed

et al. 2014

American Journal of Transplantation

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Induction therapy with alemtuzumab followed by lower maintenance immunosuppression (IS) has been associated with reduced morbidity and mortality in abdominal and heart transplantation (TX). In the current study, alemtuzumab, in combination with reduced levels of maintenance IS, was compared to thymoglobulin in combination with standard IS. Sixty consecutive patients who underwent lung transplantation (LUTX) at a single center were prospectively randomized in two groups: group A received alemtuzumab in conjunction with reduced doses of tacrolimus, steroids and mycophenolate mofetil. Group B received thymoglobulin in association with standard dose IS. Patient and graft survival, freedom from acute cellular rejection (ACR), lymphocytic bronchiolitis, bronchiolitis obliterans syndrome, kidney function, infectious complications and posttransplant lymphoproliferative disorder were analyzed. Alemtuzumab induction therapy resulted in complete the absence of ACR episodes ! A2 within the first year post-TX. The difference to thymoglobulin was significant (alemtuzumab 0 vs. ATG 0.33; p ¼ 0.019). All other factors studied did not show any differences between the two groups. Alemtuzumab induction therapy after LUTX in combination with reduced maintenance IS significantly reduces higher-grade rejection rates. This novel therapeutic agent had no impact on survival, infections rates, kidney function and incidence of malignancies.

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Section: Discussionmentioning

confidence: 99%

Alemtuzumab in Lung Transplantation: An Open-Label, Randomized, Prospective Single Center Study

Jaksch

Ankersmit

Scheed

et al. 2014

American Journal of Transplantation

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“…mune dysfunction is particularly intense with the use of lymphocytedepleting drugs, as either induction or re jection therapy, such as muromonabCD3 (OKT3) and antithymocyte globulin [37,38] . When alemtuzumab, an antiCD52 lymphocytic antibody, is used for shortcour se induction therapy only, the risk of developing CMV disease is low [39,40] . However, when patients receive alem tuzumab as rejection therapy, the risk of developing CMV disease is higher, suggesting that rejection per se also in creases the risk [40] .…”

Section: Drug-induced Immunodeficiencymentioning

confidence: 99%

Current concepts on cytomegalovirus infection after liver transplantation

Lee

Razonable

2010

WJH

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Cytomegalovirus (CMV) is the most common viral pathogen that negatively impacts on the outcome of liver transplantation. CMV cause febrile illness often accompanied by bone marrow suppression, and in some cases, invades tissues including the transplanted allograft. In addition, CMV has been significantly asso ciated with an increased predisposition to allograft rejection, accelerated hepatitis C recurrence, and other opportunistic infections, as well as reduced overall pa tient and allograft survival. To negate the adverse effects of CMV on outcome, its prevention, whether through antiviral prophylaxis or preemptive therapy, is regarded as an essential component to the medical management of liver transplant patients. Two recent guidelines have suggested that antiviral prophylaxis or preemptive therapy are similarly effective in preventing CMV disease in modest-risk CMV-seropositive liver trans plant recipients, while antiviral prophylaxis is the preferred strategy over preemptive therapy for the preven tion of CMV disease in high-risk recipients [CMV-seronegative recipients of liver allografts from CMV-seropositive donors (D+/R-)]. However, antiviral prophylaxis has only delayed the onset of CMV disease in many CMV D+/R-liver transplant recipients, and at least in one study, such occurrence of late-onset primary CMV disease was significantly associated with increased mortality after liver transplantation. Therefore, optimized strategies for prevention are needed, and aggressive treatment of CMV infection and disease should be pursued. The standard treatment of CMV disease consists of intravenous ganciclovir or oral valganciclovir, and if feasible, one should also reduce the degree of immunosuppression. In one recent controlled clinical trial, val ganciclovir was found to be as effective and safe as intravenous ganciclovir for the treatment of mild to mo derate CMV disease in solid organ (including liver) tran splant recipients. In this article, the authors review the current state and the future perspectives of prevention and treatment of CMV disease after liver transplantation.

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“…Although effective, it was associated with an unacceptable risk of infection, which has not been a feature of its use for induction therapy. 7,8 It is associated with a modest first-dose cytokine-mediated syndrome, which is ameliorated by pre-medicating with methylprednisolone. When used to treat autoimmune disease, alemtuzumab was associated with the development of new autoimmune disorders 9 ; this has not occurred in SOT recipients.…”

Section: Discussionmentioning

confidence: 99%

Alemtuzumab (Campath-1H) Induction in a Pediatric Heart Transplant: Successful Outcome and Rationale for Its Use

Das

Shoemaker

Recto

et al. 2008

The Journal of Heart and Lung Transplantation

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Campath-1H Induction and the Incidence of Infectious Complications in Adult Renal Transplantation

Abstract: Campath-1H induction for renal transplantation appears to have a low incidence of associated infectious complications when compared to historical regimens.

Cited by 58 publications

References 11 publications

Alemtuzumab in Lung Transplantation: An Open-Label, Randomized, Prospective Single Center Study

Alemtuzumab in Lung Transplantation: An Open-Label, Randomized, Prospective Single Center Study

Current concepts on cytomegalovirus infection after liver transplantation

Alemtuzumab (Campath-1H) Induction in a Pediatric Heart Transplant: Successful Outcome and Rationale for Its Use

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