The Impact of Campath 1H Induction in Adult Liver Allotransplantation

• Published in: Transplantation proceedings 2005-03, Vol.37 (2), p.1203-1204
• Main Authors: Tryphonopoulos, P., Madariaga, J.R., Kato, T., Nishida, S., Levi, D.M., Moon, J., Selvaggi, G., De Faria, W., Regev, A., Bejarano, P., Khaled, A., Safdar, K., Esquenazi, V., Weppler, D., Yoshida, H., Ruiz, P., Miller, J., Tzakis, A.G.
• Format: Article
• Language: English
• Subjects: Adult; Alemtuzumab; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Antibodies, Neoplasm - therapeutic use; Biological and medical sciences; Drug Therapy, Combination; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - prevention & control; Graft Survival; Humans; Immunosuppressive Agents - therapeutic use; Liver Transplantation - immunology; Liver Transplantation - mortality; Male; Medical sciences; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Tacrolimus - therapeutic use; Time Factors; Tissue, organ and graft immunology; Transplantation, Homologous - immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.12.157

We report our experience with Campath 1H in adult liver allotransplantation. Between December 2001 and February 2004, 77 patients underwent liver transplantation using Campath 1H induction and low-dose maintenance tacrolimus immunosuppression. The control group consisted of 50 patients with similar baseline characteristics and the same eligibility criteria, transplanted under our standard Tacrolimus/steroids regimen. Hepatitis C patients were excluded from the study. Patient and graft survival were similar for both groups. The incidence of rejection was significantly lower in the Campath vs the control group (51% vs 65% at 12 months, P = .009). Tacrolimus trough levels and conversion from Tacrolimus or the addition of other immunosuppressive drugs due to nephrotoxicity were also significantly lower in the Campath 1H group. Campath 1H induction with low-dose Tacrolimus maintenance immunosuppression is an effective regimen in reducing acute rejection in adult liver transplantation, while maintaining lower tacrolimus levels and less nephrotoxicity than our conventional immunosuppressive regimen.