[OKT 3 treatment of kidney transplant recipients].
Anti-rejection therapy with the monoclonal antibody OKT 3 was effective in the treatment of acute rejection episodes in 66% (47/71) of OKT 3 treated kidney graft recipients. The success of OKT 3 therapy, however, appeared to be dependent on certain variables. Reversal of rejection differed significantly according to the indication, namely if patients were treated first line, as opposed to rescue therapy. Vascular components of rejection and/or severe interstitial rejection, as well as acute tubular necrosis were associated with a worse reversal rate. Non-responders to OKT 3 presented with significantly lower serum OKT 3 trough levels during the first three days of the treatment course. The presence of more than one of these risk factors was shown to decrease the reversal rate of rejection significantly. The variables appeared to exert their influence in an additive fashion. Administration of OKT 3 led to the induction of an acute phase reaction, which could be detected within one day after start of therapy. The incidence of both bacterial and viral infection was increased dramatically in OKT 3 treated patients as compared with graft recipients who were not treated with monoclonal or polyclonal antilymphocyte antibodies. The findings demonstrate that OKT 3 is of value in the treatment of acute rejection episodes but provide evidence of differential indications for OKT 3 therapy, which must be taken into account to optimize control of rejection and avoid unnecessary side effects where the drug is not indicated.
Zlabinger
G J
GJ
Institut für Immunologie, Universität Wien.
Ulrich
W
W
Pohanka
E
E
Kovarik
J
J
D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D006084:Graft Rejection / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000276:immunology*; D016853:Muromonab-CD3; D011183:Postoperative Complications / Q000628:therapy*
D000911:Antibodies, Monoclonal; D016853:Muromonab-CD3
OKT 3-Therapie bei Nierentransplantatempfängern.