| Abstract | dc.description.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. | en_US |
