Campath-1H in renal transplantation: The University of Wisconsin experience

Surgery. 2004 Oct;136(4):754-60. doi: 10.1016/j.surg.2004.06.015.

Abstract

Background: Immune cell depletion is known to prevent renal allograft rejection and injury. We evaluated the humanized monoclonal antibody Campath-1H (alemtuzumab; ILEX Oncology, San Antonio, Texas) in renal transplant recipients for its safety and efficacy in preventing rejection when used in combination with a calcineurin inhibitor, mycophenolate mofetil, and low-dose steroid therapy.

Methods: One hundred twenty-six consecutive renal allograft recipients received 2 doses of Campath-1H antibody on days 0 and 1. Outcomes were compared to patients who received an anti-CD25 antibody (n=799), Thymoglobulin (n=160), or other antibody treatment (n=156) in combination with a calcineurin inhibitor, mycophenolate mofetil, and higher dose steroids.

Results: The Campath-1H group overall experienced less rejection than the other 3 groups (P=.037). Patients with delayed graft function experienced less rejection with Campath-1H than control groups (P=.0096) and improved graft survival (P=.0119). There was no difference in infection or malignancies between the 4 groups.

Conclusions: Campath-1H was well tolerated in renal transplant patients and led to significant reductions in incidence of rejection. Patients with delayed graft function experienced significantly improved graft survival.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Alemtuzumab
  • Antibodies, Monoclonal / immunology
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm / immunology
  • Antibodies, Neoplasm / therapeutic use*
  • Basiliximab
  • Cohort Studies
  • Daclizumab
  • Female
  • Graft Rejection / epidemiology
  • Graft Rejection / prevention & control*
  • Graft Survival / drug effects*
  • Humans
  • Immunoglobulin G / immunology
  • Immunoglobulin G / therapeutic use
  • Immunosuppressive Agents / immunology
  • Immunosuppressive Agents / therapeutic use*
  • Incidence
  • Kidney Transplantation / immunology*
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Mycophenolic Acid / analogs & derivatives*
  • Mycophenolic Acid / therapeutic use
  • Recombinant Fusion Proteins*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm
  • Immunoglobulin G
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Alemtuzumab
  • Basiliximab
  • Daclizumab
  • Mycophenolic Acid
  • Methylprednisolone