Effective induction immunosuppression for cadaver renal transplantation at the St. Francis Regional Medical Center.
The OKT3 induction protocol, when compared to a conventional drug protocol, resulted in an improvement in both short- and long-term patient and graft survival, especially in patients receiving a primary transplant. The 1-year allograft survival in primary transplants receiving OKT3 induction was 91% and the T1/2 of 13.5 years. This was accomplished while still being able to minimize the total drug dose of Aza, Pred, and CsA, thereby minimizing clinical complications. The use of OKT3 did not increase infections or malignant complications. This resultant significant improvement supports the passenger leukocyte theory of stimulation for allograft rejection. Further graft survival improvement in histodisparate allografts might be accomplished by OKT3 induction in concert with other methodologies that can control this cell type. The HLA antigens may not be as large an obstacle to grafting as previously suggested.
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University of Kansas School of Medicine, Wichita.
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D002102:Cadaver; D003524:Cyclosporins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007615:Kansas; D016030:Kidney Transplantation / Q000276:immunology*; D016853:Muromonab-CD3; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D003524:Cyclosporins; D016853:Muromonab-CD3; D001379:Azathioprine; D011241:Prednisone