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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Kidney transplantation is the treatment of choice in the paediatric population with end-stage renal disease &#40;ESRD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> There are few studies evaluating the long-term effectiveness and safety of alemtuzumab for kidney transplantation in the paediatric population&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">This is a descriptive study conducted at the Hospital Pablo Tob&#243;n Uribe &#40;HPTU&#41;&#46; All kidney transplant patients under 18 years of age from 2005 to 2012 who received alemtuzumab as induction therapy were included&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The immunosuppression protocol used included administering alemtuzumab and a triple maintenance therapy&#44; with a calcineurin inhibitor &#40;tacrolimus or cyclosporine&#41;&#44; antimetabolite &#40;azathioprine or mycophenolate&#41;&#44; and steroids&#46; This study was approved by the Hospital Pablo Tob&#243;n Uribe ethics committee&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">During 2005&#8211;2012&#44; 21 paediatric kidney transplants were performed with alemtuzumab received as the induction therapy&#59; 57&#46;1&#37; were boys&#44; and the median age was 13 years &#40;p25&#8211;75&#58; 9&#8211;15&#41;&#59; malformations of the urinary tract were the most common cause of chronic kidney disease &#40;42&#46;9&#37;&#41;&#46; The serological status for cytomegalovirus was recipient negative&#47;donor positive in 23&#46;8&#37;&#44; recipient positive&#47;donor positive in 71&#46;4&#37;&#44; and recipient positive&#47;donor negative in 4&#46;8&#37;&#46; The median cold ischaemia time was 18<span class="elsevierStyleHsp" style=""></span>h &#40;p25&#8211;75&#58; 12&#8211;20&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The 6-&#44; 12-&#44; 24-&#44; 36-&#44; and 60-month patient survival rate after the kidney transplant was 100&#37;&#44; 100&#37;&#44; 95&#46;2&#37;&#44; 95&#46;2&#37;&#44; and 95&#46;2&#37;&#44; respectively&#46; One patient died during the study&#46; Post-transplant 6-&#44; 12-&#44; 24-&#44; 36-&#44; and 60-month kidney graft survival were 95&#46;2&#37;&#44; 95&#46;2&#37;&#44; 90&#46;5&#37;&#44; 85&#46;7&#37;&#44; and 85&#46;7&#37;&#44; respectively&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The median GFR 1 week&#44; and 1&#44; 2&#44; and 5 years after the transplant were&#58; 72&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;p25&#8211;75&#58; 45&#8211;94&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&#44; 70&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;p25&#8211;75&#58; 61&#8211;88&#46;5&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; 89<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;p25&#8211;75&#58; 66&#8211;108&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&#44; and 76<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;p25&#8211;75&#58; 61&#8211;101&#46;5&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&#44; respectively&#46; At 1&#44; 2&#44; and 5 years of follow-up&#44; 28&#46;6&#37;&#44; 19&#46;1&#37;&#44; and 29&#46;4&#37; of patients&#44; respectively&#44; presented a GFR under 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; By grouping the patients according to CKD stage&#44; we found that&#44; during the 5-year follow-up&#44; a high percentage of patients were in stage 1 and 2 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes the main complications found&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">This study describes the clinical outcomes of paediatric kidney transplant patients who received alemtuzumab as induction therapy&#46; Among the most important findings&#44; a good kidney graft survival stands out&#44; with a low incidence of rejection and few complications&#46; One patient who lost the graft 18 months after transplantation died&#46; The patient was admitted&#44; placed on haemodialysis and died due to decompensated heart failure&#46; The other three patients who lost the kidney graft were secondary to acute rejection&#44; due to poor adherence to the immunosuppressant therapy&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Other benefits that we found with the use of this therapy was GFR stability over time&#46; Furthermore&#44; in our study&#44; only 28&#46;6&#37;&#44; 19&#46;1&#37;&#44; and 29&#46;4&#37; of the patients had a GFR under 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> at 1&#44; 2&#44; and 5 years&#46; According to this&#44; most of the study population remained in stage 1 and 2 chronic kidney disease during the follow-up period&#44; which involves a low future risk of kidney disease-related complications&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The cumulative 1-&#44; 2-&#44; and 5-year incidence of acute rejection in our patients was 14&#46;3&#37;&#44; 21&#46;1&#37;&#44; and 35&#46;7&#37;&#44; respectively&#46; Poor adherence to the immunosuppressant treatment was documented in all these patients&#44; and 3 of them subsequently lost the kidney graft&#46; Only one of the rejections was classified as antibody-mediated&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">One of the main fears with the use of alemtuzumab has been its safety profile&#46; In this study&#44; the incidence of CMV infection was found to be 23&#46;8&#37; in the year after transplant&#44; which is very high in comparison with other studies&#44; and which can be explained because we did not use universal prophylaxis against this virus&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2&#8211;9</span></a> As for other infectious complications such as BK virus and tuberculosis&#44; both infections only presented in one patient throughout the entire follow-up period &#40;incidence of 1&#46;1&#37; person-years&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">During the follow-up period&#44; which had a median of 6 years&#44; no cases of PTLD was documented in the study population&#44; which is consistent with the literature<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a>&#59; in addition&#44; 23&#46;8&#37; of the patients in this cohort were seronegative for the Epstein&#8211;Barr virus&#46; None of the studies with which we compared our outcomes found cases of PTLD&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;7&#8211;9&#44;11</span></a> One of the possible explanations why alemtuzumab has a low rate of PTLD is its T and B lymphocyte depletion effect&#44; which arguably prevents abnormal lymphocyte clone proliferation&#44; as the clones cause this type of lymphoproliferative disorder&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; induction immunosuppression therapy with alemtuzumab&#44; in paediatric kidney transplant recipients&#44; is effective in preventing acute rejection&#44; provides a suitable short- and long-term safety profile&#44; encourages an adequate glomerular filtration rate&#44; and good patient and kidney graft survival&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; V&#233;lez-Echeverri C&#44; Guerrero-Tinoco GA&#44; Villafa&#241;e-Berm&#250;dez DR&#44; Nieto-R&#237;os JF&#44; Serna-Higuita LM&#44; Serna-Campuzano A&#44; et al&#46; Alemtuzumab en trasplante renal pedi&#225;trico&#58; experiencia de 5 a&#241;os en el Hospital Pablo Tob&#243;n Uribe de Medell&#237;n&#44; Colombia&#46; Nefrologia&#46; 2016&#59;36&#58;709&#8211;711&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Stage of chronic kidney disease&#44; grouped by time of progression in the paediatric kidney transplant population at HPTU 2005&#8211;2012&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">One-year incidence percentage<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">One-year incidence rate &#40;events person-years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">5-Year incidence rate &#40;events person-years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Delayed graft function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;9&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;1&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">One-year acute graft rejection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;6&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CMV infections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;23&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;7&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BK virus infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;2&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;1&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tuberculosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;2&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;1&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
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                      "titulo" => "Alemtuzumab &#40;CAMPATH-1H&#41; for the treatment of acute rejection in kidney transplant recipients&#58; long-term follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
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                            0 => "M&#46;R&#46; Clatworthy"
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                            0 => "R&#46;D&#46; Morgan"
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                            2 => "S&#46;R&#46; Knight"
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                  "host" => array:1 [
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                      "doi" => "10.1097/TP.0b013e318257ad41"
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                          "etal" => true
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                      "autores" => array:1 [
                        0 => array:2 [
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Letter to the Editor
Alemtuzumab in paediatric kidney transplantation, five years’ experience at the Pablo Tobón Uribe Hospital in Medellín, Colombia
Alemtuzumab en trasplante renal pediátrico: experiencia de 5 años en el Hospital Pablo Tobón Uribe de Medellín, Colombia
Catalina Vélez-Echeverria,b, Gustavo Adolfo Guerrero-Tinocoa, Douglas Ramón Villafañe-Bermúdeza, John Fredy Nieto-Ríosa,b,
Corresponding author
johnfredynieto@gmail.com

Corresponding author.
, Lina María Serna-Higuitaa,b, Angélica Serna-Campuzanoc, Juan José Vanegas-Ruiza,b
a Universidad de Antioquia, Medellín, Antioquia, Colombia
b Hospital Pablo Tobón Uribe, Medellín, Antioquia, Colombia
c Universidad Pontificia Bolivariana, Medellín, Antioquia, Colombia
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    "titulo" => "Alemtuzumab in paediatric kidney transplantation&#44; five years&#8217; experience at the Pablo Tob&#243;n Uribe Hospital in Medell&#237;n&#44; Colombia"
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        "autoresLista" => "Catalina V&#233;lez-Echeverri, Gustavo Adolfo Guerrero-Tinoco, Douglas Ram&#243;n Villafa&#241;e-Berm&#250;dez, John Fredy Nieto-R&#237;os, Lina Mar&#237;a Serna-Higuita, Ang&#233;lica Serna-Campuzano, Juan Jos&#233; Vanegas-Ruiz"
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        "titulo" => "Alemtuzumab en trasplante renal pedi&#225;trico&#58; experiencia de 5 a&#241;os en el Hospital Pablo Tob&#243;n Uribe de Medell&#237;n&#44; Colombia"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Stage of chronic kidney disease&#44; grouped by time of progression in the paediatric kidney transplant population at HPTU 2005&#8211;2012&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Kidney transplantation is the treatment of choice in the paediatric population with end-stage renal disease &#40;ESRD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> There are few studies evaluating the long-term effectiveness and safety of alemtuzumab for kidney transplantation in the paediatric population&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">This is a descriptive study conducted at the Hospital Pablo Tob&#243;n Uribe &#40;HPTU&#41;&#46; All kidney transplant patients under 18 years of age from 2005 to 2012 who received alemtuzumab as induction therapy were included&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The immunosuppression protocol used included administering alemtuzumab and a triple maintenance therapy&#44; with a calcineurin inhibitor &#40;tacrolimus or cyclosporine&#41;&#44; antimetabolite &#40;azathioprine or mycophenolate&#41;&#44; and steroids&#46; This study was approved by the Hospital Pablo Tob&#243;n Uribe ethics committee&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">During 2005&#8211;2012&#44; 21 paediatric kidney transplants were performed with alemtuzumab received as the induction therapy&#59; 57&#46;1&#37; were boys&#44; and the median age was 13 years &#40;p25&#8211;75&#58; 9&#8211;15&#41;&#59; malformations of the urinary tract were the most common cause of chronic kidney disease &#40;42&#46;9&#37;&#41;&#46; The serological status for cytomegalovirus was recipient negative&#47;donor positive in 23&#46;8&#37;&#44; recipient positive&#47;donor positive in 71&#46;4&#37;&#44; and recipient positive&#47;donor negative in 4&#46;8&#37;&#46; The median cold ischaemia time was 18<span class="elsevierStyleHsp" style=""></span>h &#40;p25&#8211;75&#58; 12&#8211;20&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The 6-&#44; 12-&#44; 24-&#44; 36-&#44; and 60-month patient survival rate after the kidney transplant was 100&#37;&#44; 100&#37;&#44; 95&#46;2&#37;&#44; 95&#46;2&#37;&#44; and 95&#46;2&#37;&#44; respectively&#46; One patient died during the study&#46; Post-transplant 6-&#44; 12-&#44; 24-&#44; 36-&#44; and 60-month kidney graft survival were 95&#46;2&#37;&#44; 95&#46;2&#37;&#44; 90&#46;5&#37;&#44; 85&#46;7&#37;&#44; and 85&#46;7&#37;&#44; respectively&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The median GFR 1 week&#44; and 1&#44; 2&#44; and 5 years after the transplant were&#58; 72&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;p25&#8211;75&#58; 45&#8211;94&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&#44; 70&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;p25&#8211;75&#58; 61&#8211;88&#46;5&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; 89<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;p25&#8211;75&#58; 66&#8211;108&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&#44; and 76<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;p25&#8211;75&#58; 61&#8211;101&#46;5&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&#44; respectively&#46; At 1&#44; 2&#44; and 5 years of follow-up&#44; 28&#46;6&#37;&#44; 19&#46;1&#37;&#44; and 29&#46;4&#37; of patients&#44; respectively&#44; presented a GFR under 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; By grouping the patients according to CKD stage&#44; we found that&#44; during the 5-year follow-up&#44; a high percentage of patients were in stage 1 and 2 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes the main complications found&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">This study describes the clinical outcomes of paediatric kidney transplant patients who received alemtuzumab as induction therapy&#46; Among the most important findings&#44; a good kidney graft survival stands out&#44; with a low incidence of rejection and few complications&#46; One patient who lost the graft 18 months after transplantation died&#46; The patient was admitted&#44; placed on haemodialysis and died due to decompensated heart failure&#46; The other three patients who lost the kidney graft were secondary to acute rejection&#44; due to poor adherence to the immunosuppressant therapy&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Other benefits that we found with the use of this therapy was GFR stability over time&#46; Furthermore&#44; in our study&#44; only 28&#46;6&#37;&#44; 19&#46;1&#37;&#44; and 29&#46;4&#37; of the patients had a GFR under 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> at 1&#44; 2&#44; and 5 years&#46; According to this&#44; most of the study population remained in stage 1 and 2 chronic kidney disease during the follow-up period&#44; which involves a low future risk of kidney disease-related complications&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The cumulative 1-&#44; 2-&#44; and 5-year incidence of acute rejection in our patients was 14&#46;3&#37;&#44; 21&#46;1&#37;&#44; and 35&#46;7&#37;&#44; respectively&#46; Poor adherence to the immunosuppressant treatment was documented in all these patients&#44; and 3 of them subsequently lost the kidney graft&#46; Only one of the rejections was classified as antibody-mediated&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">One of the main fears with the use of alemtuzumab has been its safety profile&#46; In this study&#44; the incidence of CMV infection was found to be 23&#46;8&#37; in the year after transplant&#44; which is very high in comparison with other studies&#44; and which can be explained because we did not use universal prophylaxis against this virus&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2&#8211;9</span></a> As for other infectious complications such as BK virus and tuberculosis&#44; both infections only presented in one patient throughout the entire follow-up period &#40;incidence of 1&#46;1&#37; person-years&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">During the follow-up period&#44; which had a median of 6 years&#44; no cases of PTLD was documented in the study population&#44; which is consistent with the literature<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a>&#59; in addition&#44; 23&#46;8&#37; of the patients in this cohort were seronegative for the Epstein&#8211;Barr virus&#46; None of the studies with which we compared our outcomes found cases of PTLD&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;7&#8211;9&#44;11</span></a> One of the possible explanations why alemtuzumab has a low rate of PTLD is its T and B lymphocyte depletion effect&#44; which arguably prevents abnormal lymphocyte clone proliferation&#44; as the clones cause this type of lymphoproliferative disorder&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; induction immunosuppression therapy with alemtuzumab&#44; in paediatric kidney transplant recipients&#44; is effective in preventing acute rejection&#44; provides a suitable short- and long-term safety profile&#44; encourages an adequate glomerular filtration rate&#44; and good patient and kidney graft survival&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; V&#233;lez-Echeverri C&#44; Guerrero-Tinoco GA&#44; Villafa&#241;e-Berm&#250;dez DR&#44; Nieto-R&#237;os JF&#44; Serna-Higuita LM&#44; Serna-Campuzano A&#44; et al&#46; Alemtuzumab en trasplante renal pedi&#225;trico&#58; experiencia de 5 a&#241;os en el Hospital Pablo Tob&#243;n Uribe de Medell&#237;n&#44; Colombia&#46; Nefrologia&#46; 2016&#59;36&#58;709&#8211;711&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">One-year incidence percentage<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">One-year incidence rate &#40;events person-years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">5-Year incidence rate &#40;events person-years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Delayed graft function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;9&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;1&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">One-year acute graft rejection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;6&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CMV infections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;23&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;7&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BK virus infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;2&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;1&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tuberculosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;2&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;1&#37; person-years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pediatric transplantation in the United States&#44; 1996&#8211;2005"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Horslen"
                            1 => "M&#46; Barr"
                            2 => "L&#46; Christensen"
                            3 => "R&#46; Ettenger"
                            4 => "J&#46; Magee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Transpl"
                        "fecha" => "2007"
                        "volumen" => "7"
                        "paginaInicial" => "1339"
                        "paginaFinal" => "1358"
                      ]
                    ]
                  ]
                ]
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              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alemtuzumab &#40;CAMPATH-1H&#41; for the treatment of acute rejection in kidney transplant recipients&#58; long-term follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Clatworthy"
                            1 => "P&#46;J&#46; Friend"
                            2 => "R&#46;Y&#46; Calne"
                            3 => "P&#46;R&#46;U&#46; Rebello"
                            4 => "G&#46; Hale"
                            5 => "H&#46; Waldmann"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1097/TP.0b013e31819d3353"
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ISSN: 20132514
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