Induction therapy in adult intestinal transplantation: reduced incidence of rejection with "2‐dose" alemtuzumab protocol. (2nd July 2013) - Lauro, A.
Abstract The incidence of early rejection after intestinal transplantation correlates with heightened risk of graft loss and mortality. Many different induction or pre‐conditioning protocols have been reported in the last 10 yr to improve outcomes; however, sepsis remains prevalent and diminishes long‐term results. We recently began a "2‐dose" alemtuzumab trial protocol – 15 mg at day 0 and 15 mg repeated on day 7 – with the hope of reducing our infection rate. We compared three different protocols used at our institution (daclizumab, conventional "4‐dose" alemtuzumab, and "2‐dose" alemtuzumab). There was a significantly lower rate of early rejection with the "2‐dose" alemtuzumab protocol in our study group of mainly (88%) intestinal grafts without accompanying liver engraftment with its protective immunologic effect. Sepsis remained low. Longer follow‐up will be required to evaluate the effects of this new protocol on longer‐term outcomes.