Alemtuzumab pre-conditioning with tacrolimus monotherapy in pediatric renal transplantation

Am J Transplant. 2007 Dec;7(12):2736-8. doi: 10.1111/j.1600-6143.2007.01987.x. Epub 2007 Oct 1.

Abstract

We employed antibody pre-conditioning with alemtuzumab and posttransplant immunosuppression with low-dose tacrolimus monotherapy in 26 consecutive pediatric kidney transplant recipients between January 2004 and December 2005. Mean recipient age was 10.7 +/- 5.8 years, 7.7% were undergoing retransplantation, and 3.8% were sensitized, with a PRA >20%. Mean donor age was 32.8 +/- 9.2 years. Living donors were utilized in 65% of the transplants. Mean cold ischemia time was 27.6 +/- 6.4 h. The mean number of HLA mismatches was 3.3 +/- 1.3. Mean follow-up was 25 +/- 8 months. One and 2 year patient survival was 100% and 96%. One and 2 year graft survival was 96% and 88%. Mean serum creatinine was 1.1 +/- 0.6 mg/dL, and calculated creatinine clearance was 82.3 +/- 29.4 mL/min/1.73 m(2). The incidence of pre-weaning acute rejection was 11.5%; the incidence of delayed graft function was 7.7%. Eighteen (69%) of the children were tapered to spaced tacrolimus monotherapy, 10.5 +/- 2.2 months after transplantation. The incidence of CMV, PTLD and BK virus was 0%; the incidence of posttransplant diabetes was 7.7%. Although more follow-up is clearly needed, antibody pre-conditioning with alemtuzumab and tacrolimus monotherapy may be a safe and effective regimen in pediatric renal transplantation.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Alemtuzumab
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm / therapeutic use*
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control*
  • Graft Survival / immunology
  • Humans
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Kidney / physiology
  • Kidney Transplantation / immunology*
  • Kidney Transplantation / methods
  • Tacrolimus / therapeutic use*
  • Transplantation Conditioning / methods*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm
  • Immunosuppressive Agents
  • Alemtuzumab
  • Tacrolimus