Magliocca J F, Odorico J S, Pirsch J D, Becker Y T, Knechtle S J, Leverson G E, Sollinger H W
Division of Transplantation, Department of Surgery, The University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Am J Transplant. 2008 Aug;8(8):1702-10. doi: 10.1111/j.1600-6143.2008.02299.x.
Alemtuzumab is a humanized, rat monoclonal antibody directed against the CD52 antigen. After binding, alemtuzumab causes profound and durable depletion and has been successfully used as immune induction therapy for organ transplantation. This was a single center, retrospective review of patients who underwent simultaneous pancreas-kidney transplantation at the University of Wisconsin using alemtuzumab induction therapy compared with historical controls that received induction with basiliximab. There were no differences in donor or recipient demographics, rates of patient survival, renal or pancreas allograft survival, renal allograft delayed graft function, EBV infection, BKV infection, PTLD or sepsis. There was a statistically significant increase in the incidence of cytomegalovirus (CMV) infection in the alemtuzumab-treated group. Given the significantly higher incidence of CMV infections, we have since altered our induction protocol to consist of a single 30 mg dose of alemtuzumab instead of two doses. The long-term effects of this change remain to be seen. Due to the results seen in this study, the low initial cost of the drug and the absence of any severe, short-term side effects, alemtuzumab has been selected as the induction drug of choice at our center for patients undergoing SPK.
阿仑单抗是一种针对CD52抗原的人源化大鼠单克隆抗体。结合后，阿仑单抗会导致深度且持久的淋巴细胞耗竭，并已成功用作器官移植的免疫诱导疗法。这是一项单中心回顾性研究，比较了在威斯康星大学接受阿仑单抗诱导治疗的同期胰肾联合移植患者与接受巴利昔单抗诱导治疗的历史对照患者。供体或受体的人口统计学特征、患者生存率、肾或胰腺移植存活率、肾移植延迟肾功能恢复、EB病毒感染、BK病毒感染、移植后淋巴增殖性疾病或败血症发生率均无差异。阿仑单抗治疗组的巨细胞病毒（CMV）感染发生率有统计学意义的增加。鉴于CMV感染发生率显著更高，我们此后改变了诱导方案，采用单次30mg剂量的阿仑单抗而非两次剂量。这一改变的长期影响仍有待观察。鉴于本研究的结果、该药物较低的初始成本以及不存在任何严重的短期副作用，阿仑单抗已被选为我们中心接受胰肾联合移植患者的首选诱导药物。
