The use of campath-1H as induction therapy in renal transplantation: Preliminary results
The use of campath-1H as induction therapy in renal transplantation: Preliminary results
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DOI：
10.1097/01.tp.0000128625.29654.eb
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发表时间：
2004-08-15
期刊：
影响因子：
6.2
通讯作者：
Miller, J
中科院分区：
文献类型：
--
作者：
Ciancio, G;Burke, GW;Miller, J
背景。为了减少初始和长期（肾毒性）钙调神经磷酸酶抑制剂维持剂量并完全消除维持皮质类固醇，阿仑单抗（Campath-1H）被用作第一具尸体和非 HLA 一致活体供体肾移植的诱导治疗。方法。 44 名同种异体肾移植受者在术后第 0 天和第 4 天接受 Campath-1H (0.3 mg/kg) 治疗，随后静脉推注甲泼尼龙。从一开始就可维持 12 小时他克莫司谷浓度为 5 至 7 ng/mL，并且（减少）吗替麦考酚酯剂量为每天两次 500 mg。术后第一周后计划不给予皮质类固醇。结果。中位随访时间为 9（范围：1-19）个月，患者和移植物的存活率均为 100%。经活检证实，四名患者诊断为急性排斥反应。四名患者出现感染，需要住院治疗。三十八名接受者仍然不需要长期皮质类固醇治疗。结论。在早期评估中，Campath-1H、低剂量他克莫司和吗替麦考酚酯以及避免维持皮质类固醇的使用的组合似乎对肾移植受者来说是安全有效的。长期结果将在未来报告。
Background. In an attempt to reduce both initial and long-term (nephrotoxic) calcineurin inhibitor maintenance dosage and totally eliminate maintenance corticosteroids, alemtuzumab (Campath-1H) was used as induction therapy in first cadaver and non-HLA-identical living donor renal transplantation.Methods. Forty-four de novo renal allograft recipients were treated with Campath-1H (0.3 mg/kg) on days 0 and 4 postoperatively, preceded by methylprednisolone boluses. Maintenance target 12-hr tacrolimus trough levels of 5 to 7 ng/mL were operational from the outset as well as (reduced) mycophenolate mofetil dosage of 500 mg twice daily. No corticosteroids were planned to be given after the first week postoperatively.Results. With a median follow-up of 9 (range, 1-19) months, patient and graft survival rates are each at 100%. Biopsy-proven acute rejection was diagnosed in four patients. Infections requiring hospitalization developed in four patients. Thirty-eight recipients remain without the need for long-term corticosteroid therapy.Conclusions. In an early assessment, the combination of Campath-1H, low dosing of tacrolimus and mycophenolate mofetil, and avoidance of maintenance corticosteroid use seems to be safe and effective for kidney transplant recipients. Long-term outcomes will be reported in the future.