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

Thai, NL and Khan, A and Tom, K and Blisard, D and Basu, A and Tan, HP and Marcos, A and Fung, JJ and Starzl, TE and Shapiro, R (2006) Alemtuzumab induction and tacrolimus monotherapy in pancreas transplantation: One- and two-year outcomes. Transplantation, 82 (12). 1621 - 1624. ISSN 0041-1337

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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. © 2006 Lippincott Williams & Wilkins, Inc.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Thai, NL
Khan, A
Tom, K
Blisard, D
Basu, A
Tan, HP
Marcos, A
Fung, JJ
Starzl, TEtes11@pitt.eduTES11
Shapiro, R
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 December 2006
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 82
Number: 12
Page Range: 1621 - 1624
DOI or Unique Handle: 10.1097/01.tp.0000250712.12389.3d
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062121458, Starzl CV No. 2239
Date Deposited: 08 Apr 2010 17:38
Last Modified: 04 Feb 2019 16:55
URI: http://d-scholarship.pitt.edu/id/eprint/5625

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