IMMUNOSUPPRESSION The Impact of Campath 1H Induction in Adult Liver Allotransplantation P. Tryphonopoulos, J.R. Madariaga, T. Kato, S. Nishida, D.M. Levi, J. Moon, G. Selvaggi, W. De Faria, A. Regev, P. Bejarano, A. Khaled, K. Safdar, V. Esquenazi, D. Weppler, H. Yoshida, P. Ruiz, J. Miller, and A.G. Tzakis ABSTRACT Background. We report our experience with Campath 1H in adult liver allotransplan- tation. Methods. Between December 2001 and February 2004, 77 patients underwent liver transplantation using Campath 1H induction and low-dose maintenance tacrolimus immuno- suppression. The control group consisted of 50 patients with similar baseline characteristics and the same eligibility criteria, transplanted under our standard Tacrolimus/steroids regimen. Hepatitis C patients were excluded from the study. Results. Patient and graft survival were similar for both groups. The incidence of rejection was significantly lower in the Campath vs the control group (51% vs 65% at 12 months, P = .009). Tacrolimus trough levels and conversion from Tacrolimus or the addition of other immunosuppressive drugs due to nephrotoxicity were also significantly lower in the Campath 1H group. Conclusion. Campath 1H induction with low-dose Tacrolimus maintenance immuno- suppression is an effective regimen in reducing acute rejection in adult liver transplanta- tion, while maintaining lower tacrolimus levels and less nephrotoxicity than our conven- tional immunosuppressive regimen. A LEMTUZUMAB [CAMPATH 1H (C 1H)] is a hu- manized anti-CD52 monoclonal antibody that has been used in solid organ transplantation. 1–4 In this report, we describe our experience with 1-year follow-up of liver transplant recipients that have received C 1H induction immunosuppression. METHODS We administered C 1H induction immunosuppression with low- dose tacrolimus (Tac) maintenance immunosuppression to 77 adult liver allograft recipients (40 men and 37 women) from December 2001 to February 2004 (study group G1). C 1H was administered at 0.3 mg/kg just before and at the end of the transplantation and on From the Departments of Surgery, Division of Transplantation (P.T., J.R.M., T.K., S.N., D.M.L., J.M., G.S., W.D., V.E., D.W., H.Y., P.R., J.M., A.G.T.), and Medicine, Division of Hepatology (A.R., K.S.), University of Miami School of Medicine, Miami, Florida, USA; and Department of Pathology, Division of Immu- nopathology (P.B., A.K., P.R.), University of Miami, Jackson Memorial Hospital, Miami, Florida, USA. Address reprint requests to Andreas G. Tzakis, MD, PhD, Director, Liver/GI Transplant Program, University of Miami School of Medicine, Highland Professional Building, 1801 NW 9 th Ave., Suite 511 Miami, FL 33136. E-mail: atzakis@med. miami.edu © 2005 by Elsevier Inc. All rights reserved. 0041-1345/05/$–see front matter 360 Park Avenue South, New York, NY 10010-1710 doi:10.1016/j.transproceed.2004.12.157 Transplantation Proceedings, 37, 1203–1204 (2005) 1203