Alemtuzumab with corticosteroid minimization for pediatric deceased donor renal transplantation: A seven-yr experience

Katarina Supe-Markovina, Jonathan J. Melquist, Deirdre Connolly, Heather N. Dicarlo, Wayne C. Waltzer, Richard N. Fine, Frank S. Darras

Research output: Contribution to journalArticlepeer-review

Abstract

Alemtuzumab is a monoclonal antibody targeting CD52 receptors on B and T lymphocytes and is an effective induction agent in pediatric renal transplantation. We report a seven-yr experience using alemtuzumab induction and steroid-free protocol in the pediatric population as safe and effective. Twenty-one pediatric deceased donor renal transplants were performed at a single academic institution. All received induction with single-dose alemtuzumab and were maintained on a steroid-free protocol using TAC and MMF immunosuppression. There were 15 males and six females in the study whose ages ranged from one to 19 yr. The average follow-up was 32 months (range from 12 to 78.2 months and median 33.7 ± 23.7 months). All patients had immediate graft function. Graft survival was 95%, and patient survival was 100%. Mean 12 and 36 months eGFR were 63.33 ± 21.01 and 59.90 ± 15.27 mL/min/1.73m 2, respectively. Three patients developed acute T-cell-mediated rejection due to non-adherence while no recipients developed cytomegalovirus infection, PTLD, or polyoma BK viral nephropathy. Steroid avoidance with single-dose alemtuzumab induction provides adequate and safe immunosuppression in pediatric deceased donor renal transplant recipients receiving TAC and low-dose MMF maintenance therapy.

Original languageEnglish (US)
Pages (from-to)363-368
Number of pages6
JournalPediatric transplantation
Volume18
Issue number4
DOIs
StatePublished - Jun 2014
Externally publishedYes

Keywords

  • children
  • growth
  • induction
  • monoclonal antibody
  • steroid withdrawal

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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