The reuse of OKT3 after previous rejection or induction therapy in cadaveric renal transplantation.
Twenty-three patients were retreated once and two patients were retreated two times with OKT3 after previous rejection or induction therapy in cadaveric renal transplantation. Retreatment was effective when the initial treatment was for rejection therapy or induction therapy protocols. Rejection reversal was 83% in the rejection group and 90% in the induction group. Long-term allograft function was 42% in the rejection group and 78% in the induction group. It is speculated that the immune response is more adequately controlled in the induction group. The antibody responses to retreatment were no antibody production (n = 9), antibody production on retreatment (n = 2), no change in antibody titer (n = 4), and increase in previously identified antibody titer (n = 3). Two patients with high titered antibodies had treatment failures caused by preformed antimouse antibodies. The only changes in antibody specificity occurred in patients with a change in preformed antibody. Retreatment of allograft rejection in patients previously treated with OKT3 has again been demonstrated to be effective. It is suggested that retreatment after OKT3 induction therapy may be the most effective.
Shield
C F
CF
Transplantation Service, St Francis Regional Medical Center, Wichita, KS.
Hughes
J D
JD
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002102:Cadaver; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D008775:Methylprednisolone / Q000627:therapeutic use; D016853:Muromonab-CD3
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D008775:Methylprednisolone