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

• Published in: Pediatric transplantation Vol. 21; no. 1; pp. np - n/a
• Main Authors: Das, Bibhuti, Dimas, Vivian, Guleserian, Kristine, Lacelle, Chantale, Anton, Kristin, Moore, Lindy, Morrow, Robert
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.02.2017
• Subjects: Adolescent; Alemtuzumab; alemtuzumab (Campath‐1H); Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal, Humanized - therapeutic use; Antilymphocyte serum; Antilymphocyte Serum - administration & dosage; Child; Child, Preschool; Female; Globulins; Graft rejection; Graft Rejection - prevention & control; Heart Transplantation; Humans; Immunoglobulin G; Immunoglobulin G - administration & dosage; Immunotherapy; Infant; Infusions, Intravenous; Intravenous administration; Male; Methylprednisolone; Methylprednisolone - administration & dosage; Monoclonal antibodies; Morbidity; Mycophenolic Acid - administration & dosage; pediatric heart transplant; Pediatrics; Prednisone - administration & dosage; Recombinant Fusion Proteins - administration & dosage; refractory acute rejections; Retrospective Studies; Rituximab; Rituximab - administration & dosage; Tacrolimus - administration & dosage; Thymocytes; Transplant Recipients; Transplantation; Transplants & implants; alemtuzumab (Campath-1H); refractory acute rejections; pediatric heart transplant
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/petr.12844

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.