Eight-year follow-up in pediatric living donor kidney recipients receiving alemtuzumab induction.

Autor: Kaabak MM; Organ Transplant Division, Boris Petrovsky Research Center of Surgery, Moscow, Russia., Babenko NN; Kidney Transplant Department, Boris Petrovsky Research Center of Surgery, Moscow, Russia., Shapiro R; Mount Sinai Hospital, Surgery, Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA., Maschan AA; Dmitry Rogachev Federal Clinic of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia., Zokoev AK; Kidney Transplant Department, Boris Petrovsky Research Center of Surgery, Moscow, Russia., Schekaturov SV; Kidney Transplant Department, Boris Petrovsky Research Center of Surgery, Moscow, Russia., Vyunkova JN; Kidney Transplant Department, Boris Petrovsky Research Center of Surgery, Moscow, Russia., Dymova OV; Laboratory Department, Boris Petrovsky Research Center of Surgery, Moscow, Russia.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2017 Aug; Vol. 21 (5). Date of Electronic Publication: 2017 Jun 10.
DOI: 10.1111/petr.12941
Abstrakt: Recipient lymphocytes are crucial for direct and indirect pathways of allorecognition. We proposed that the administration of alemtuzumab several weeks pretransplantation could eradicate peripheral lymphatic cells and promote donor-specific acceptance. This was a single-center, retrospective review of 101 consecutive living donor kidney transplantations in pediatric patients (age 7 months-18 years), performed between September 2006 and April 2010. IS protocol included two 30 mg doses of alemtuzumab: The first was given 12-29 days prior to transplantation, and the second at the time of transplantation. Maintenance IS was based on combination of low-dose CNI and mycophenolate, with steroids tapered over the first 5 days post-transplantation. Patients were followed for 7.8±1.3 years, and protocol biopsies were taken 1 month, 1, 3, and 5 years post-transplant. The Kaplan-Meier 8-year patient and graft survival rates in the cyclosporine-treated patients were 82.0±7.3% and 71.6±7.3, and in the tacrolimus-treated patients were 97.2±5.4 and 83.8±6.0%. Biopsy-proven acute rejection developed in 35% of cyclosporine-treated patients and in 8% of tacrolimus-treated patients. Alemtuzumab pretreatment prior to LRD kidney transplantation, followed by maintenance immunosuppression with tacrolimus and MMF, is associated with reasonable long-term results in pediatric patients.
(© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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