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Alemtuzumab induction in kidney transplantation: clinical results and impact on T-regulatory cells.

Abstract：

:Alemtuzumab (ALT), a humanized monoclonal anti-CD52 antibody, was introduced in solid organ transplantation as an induction agent. ALT associated with anticalcineurins has provided a low incidence of acute rejection episodes (ARE) and potential tolerogenic properties. We analyzed the clinical outcomes and effects on peripheral Treg of renal transplant recipients treated with ALT. Six-month data on kidney alone or kidney combined with pancreas or liver patients treated with ALT and tacrolimus (TAC) in standard doses were compared with those on renal transplant recipients of similar demography who were not treated with ALT. We evaluated patient and graft survivals, ARE incidence, hematological parameters, renal function, adverse events, and CD4+CD25+FoxP3+ T cells in peripheral blood. Demographics of recipients, donors, and transplants were similar in both groups. Mean HLA mismatch was slightly greater among ALT-treated patients (3.5 vs 2.5). No combined transplantation was performed in the ALT-untreated group. Patient and graft survivals were 100% without rejection or serious infections in both groups. ALT-treated recipients showed anemia and leukopenia in 3 patients as well as severe lymphopenia in 5 recipients, who partially recovered on day 90. Final mean plasma creatinine was 1.4 mg/dL, while calculated creatinine clearance was approximately 65 mL/min in both groups. Mean Treg cell percentage was higher among ALT-treated recipients than the comparative group or healthy controls (P < .05). In conclusion, renal transplantation results obtained using ALT with rigorous immunosuppressive therapy were excellent; serious adverse events and acute rejection were absent. The effect of the increased proportion of Treg cells must be evaluated with longer observation.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Morales J,Bono MR,Fierro A,Iñiguez R,Zehnder C,Rosemblatt M,Calabran L,Herzog C,Benavente D,Aguiló J,Pefaur J,Alba A,Ferrario M,Simon W,Contreras L,Buckel E

doi

10.1016/j.transproceed.2008.03.066

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

3223-8

issue

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(08)00284-4

journal_volume

pub_type

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Alemtuzumab induction in kidney transplantation: clinical results and impact on T-regulatory cells.