Alemtuzumab induction and tacrolimus monotherapy in pancreas transplantation: One- and two-year outcomes

Ngoc L. Thai, Akhtar Khan, Kusum Tom, Deanna Blisard, Amit Basu, Henkie P. Tan, Amadeo Marcos, John J. Fung, Thomas E. Starzl, Ron Shapiro

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

BACKGROUND. Alemtuzumab (Campath-1H) induction with tacrolimus monotherapy has been shown to provide effective immunosuppression for kidney, liver, lung, and small bowel transplantation. This drug combination was evaluated in pancreas transplant recipients. METHODS. Sixty consecutive pancreas transplants (30 simultaneous pancreas-kidney, 20 pancreas after kidney, and 10 pancreas alone) were carried out under this protocol between July 2003 to January 2005. The mean follow-up was 22 months (range 17-33). RESULTS. One-year patient, pancreas, and kidney allograft survival were 95%, 93%, and 90%, respectively. With 22 months follow-up, patient, pancreas, and kidney survival were 94%, 89%, and 87%, respectively. The rejection rate was 30% (18/60), with four patients (7%) experiencing steroid-resistant rejection. Major infection occurred in three (5%) patients resulting in two (3.3%) deaths from disseminated histoplasmosis and a herpes virus infection. One patient with cryptococcal meningitis was successfully treated. Seven (11.7%) patients experienced cytomegalovirus infection, all of whom responded to treatment with ganciclovir. One (1.7%) case of polymorphic posttransplant lymphoproliferative disease was seen, which regressed with a temporary discontinuation of tacrolimus and high-dose ganciclovir. The mean serum creatinine of the 30 simultaneous pancreas-kidney transplants at one year posttransplant was 1.37±0.33 mg/ml. The preexisting creatinine in pancreas after kidney transplants was not adversely affected by this immunosuppressive protocol. CONCLUSION. A single dose of perioperative alemtuzumab followed by daily tacrolimus monotherapy provides effective immunosuppression for pancreas transplantation, but the optimal use of this drug combination is not yet clear.

Original languageEnglish
Pages (from-to)1621-1624
Number of pages4
JournalTransplantation
Volume82
Issue number12
DOIs
StatePublished - Dec 2006
Externally publishedYes

Keywords

  • Campath
  • Immunosuppressive
  • Pancreas transplantation
  • Steroid-avoidance

Fingerprint

Dive into the research topics of 'Alemtuzumab induction and tacrolimus monotherapy in pancreas transplantation: One- and two-year outcomes'. Together they form a unique fingerprint.

Cite this