Thymoglobulin Versus Alemtuzumab Versus Daclizumab in Living Donor Renal Transplantation

To observe in a randomized prospective pilot study the effectiveness and toxicity of Thymoglobulin vs. Campath-1H used for induction therapy in recipients of living donor (LD) kidneys, compared with our standard treatment protocol of Zenapax® and maintenance immunosuppression (vide infra).

To determine the effect different antibody induction regimen on the lymphoid cell subsets of the immune system in kidney allograft recipients peripheral blood and bone marrow aspirates will be tested at surgery before transplantation and at intervals post operatively.

To treat renal transplant patients successfully in the absence of long-term calcineurin inhibition to determine if there are beneficial effects on the prevention of chronic allograft nephropathy.

Inclusion criteria

• Age >14 years
• Weight >40 kg
• Primary renal allograft:living related (non HLA identical) and unrelated donor
• Negative standard cross match for T-cells
• Signed and dated consent form

Exclusion criteria

• Patient has previously received or is receiving an organ transplant other than kidney
• Patient has received a kidney transplant from a non-heart beating donor
• Patient has received an ABO incompatible donor kidney
• Recipient or donor is seropositive for human immunodeficiency virus (HIV)
• Patient has a current malignancy or a history of malignancy