Alemtuzumab (Campath-1H) therapy for refractory rejections in pediatric heart transplant recipients

Pediatr Transplant. 2017 Feb;21(1). doi: 10.1111/petr.12844. Epub 2016 Nov 11.

Abstract

Despite substantial improvements in survival after pediatric heart transplantation, refractory rejection remains a major cause of morbidity and mortality. We have utilized ALE (Campath-1H) in six consecutive patients with refractory rejection. These rejection episodes persisted despite conventional treatment, which included intravenous methylprednisolone, rituximab, immunoglobulin G, and antithymocyte globulin. In our series, after ALE therapy, LV SF increased from 22%±5% to 33%±5% (P=.01). However, in our series, ALE therapy neither led to persistent LV function recovery nor could it prevent subsequent antibody-mediated rejection.

Keywords: alemtuzumab (Campath-1H); pediatric heart transplant; refractory acute rejections.

MeSH terms

  • Adolescent
  • Alemtuzumab
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antilymphocyte Serum / administration & dosage
  • Basiliximab
  • Child
  • Child, Preschool
  • Female
  • Graft Rejection / prevention & control*
  • Heart Transplantation*
  • Humans
  • Immunoglobulin G / administration & dosage
  • Infant
  • Infusions, Intravenous
  • Male
  • Methylprednisolone / administration & dosage
  • Mycophenolic Acid / administration & dosage
  • Prednisone / administration & dosage
  • Recombinant Fusion Proteins / administration & dosage
  • Retrospective Studies
  • Rituximab / administration & dosage
  • Tacrolimus / administration & dosage
  • Transplant Recipients

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antilymphocyte Serum
  • Immunoglobulin G
  • Recombinant Fusion Proteins
  • Alemtuzumab
  • Rituximab
  • Basiliximab
  • Mycophenolic Acid
  • Prednisone
  • Tacrolimus
  • Methylprednisolone