BACKGROUND: We combined alemtuzumab (Campath-1H, Berlex Laboratories, Montville, NJ) and tacrolimus (Tac) immunosuppression for intestinal and multivisceral transplantation. MATERIALS AND METHODS: A total of 21 adult patients received 24 grafts: 14 intestinal, nine multivisceral, and one liver-intestinal graft. Alemtuzumab was administered perioperatively in four doses with low-dose Tac (levels 10-15 ng/dL) and no maintenance steroids. Tac was substituted with sirolimus in case of Tac-related complications. Suspected or mild rejections were treated with steroids. Moderate rejections were treated with steroids or OKT3. Severe rejections were treated with OKT3. RESULTS: Of the 16 patients that were followed up for an average of 9 months, 12 are alive with functioning grafts. Two patients experienced severe rejection, three experienced moderate rejection episodes, and seven experienced mild acute rejection episodes. Four patients never developed acute rejection. Infectious complications included a cytomegalovirus enteritis and four fungal infections (related to central venous access). CONCLUSIONS: The combination of alemtuzumab and Tac therapy without steroid use seems to efficiently prevent acute rejection in a significant number of patients without causing frequent opportunistic infections.
BACKGROUND: We combined alemtuzumab (Campath-1H, Berlex Laboratories, Montville, NJ) and tacrolimus (Tac) immunosuppression for intestinal and multivisceral transplantation. MATERIALS AND METHODS: A total of 21 adult patients received 24 grafts: 14 intestinal, nine multivisceral, and one liver-intestinal graft. Alemtuzumab was administered perioperatively in four doses with low-dose Tac (levels 10-15 ng/dL) and no maintenance steroids. Tac was substituted with sirolimus in case of Tac-related complications. Suspected or mild rejections were treated with steroids. Moderate rejections were treated with steroids or OKT3. Severe rejections were treated with OKT3. RESULTS: Of the 16 patients that were followed up for an average of 9 months, 12 are alive with functioning grafts. Two patients experienced severe rejection, three experienced moderate rejection episodes, and seven experienced mild acute rejection episodes. Four patients never developed acute rejection. Infectious complications included a cytomegalovirus enteritis and four fungal infections (related to central venous access). CONCLUSIONS: The combination of alemtuzumab and Tac therapy without steroid use seems to efficiently prevent acute rejection in a significant number of patients without causing frequent opportunistic infections.
Authors: David Grant; Kareem Abu-Elmagd; Jorge Reyes; Andreas Tzakis; Alan Langnas; Thomas Fishbein; Olivier Goulet; Douglas Farmer Journal: Ann Surg Date: 2005-04 Impact factor: 12.969
Authors: Susan Shyu; Mary Amanda Dew; Joseph M Pilewski; Annette J DeVito Dabbs; Diana B Zaldonis; Sean M Studer; Maria M Crespo; Yoshiya Toyoda; Christian A Bermudez; Kenneth R McCurry Journal: J Heart Lung Transplant Date: 2011-03-21 Impact factor: 10.247
Authors: Andreas G Tzakis; Tomoaki Kato; David M Levi; Werviston Defaria; Gennaro Selvaggi; Debbie Weppler; Seigo Nishida; Jang Moon; Juan R Madariaga; Andre I David; Jeffrey J Gaynor; John Thompson; Erick Hernandez; Enrique Martinez; G Patricia Cantwell; Jeffrey S Augenstein; Anthony Gyamfi; Ernesto A Pretto; Lorraine Dowdy; Panagiotis Tryphonopoulos; Phillip Ruiz Journal: Ann Surg Date: 2005-10 Impact factor: 12.969
Authors: Y Zou; F Hernandez; E Burgos; L Martinez; S Gonzalez-Reyes; V Fernandez-Dumont; G Lopez; M Romero; M Lopez-Santamaria; J A Tovar Journal: Pediatr Surg Int Date: 2004-11-30 Impact factor: 1.827