Prophylactic therapy with OKT3 does not affect donor specific reactivity of peripheral blood lymphocytes from heart transplant recipients.
To avoid the nephrotoxic effect of high-dose cyclosporin A (CsA) immediately posttransplant, heart transplant recipients received as prophylactic therapy intravenous OKT3 for seven days instead of intravenous CsA. Patients receiving OKT3 were compared with patients receiving CsA with respect to specific proliferation and cytotoxicity of their peripheral blood mononuclear cells (PMNC) against donor antigens, at different times within three months post-transplant. No effect of the initial immunosuppressive therapy was observed on these parameters. Acute rejection did not induce a consistent effect on the relative proliferation. PMNC from patients who experienced one or more rejection episodes showed a decrease in donor specific relative proliferative response in time after transplantation, while nonrejectors did not or only slightly, independent of the initial immunosuppressive protocol. Within the group of patients not receiving OKT3, this effect of rejection reached significance. In conclusion, no effect of prophylactic OKT3 therapy compared with prophylactic CsA therapy was observed on donor reactivity of PMNC in vitro during the subsequent three to four months post-transplant.
Jutte
N H
NH
Department of Internal Medicine I, Erasmus University Rotterdam/University Hospital Rotterdam Dijkzigt, The Netherlands.
Heyse
P
P
Daane
C R
CR
Vaessen
L M
LM
Claas
F H
FH
Balk
A H
AH
Mochtar
B
B
Weimar
W
W
D001803:Blood Transfusion; D002455:Cell Division; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D003602:Cytotoxicity, Immunologic; D004359:Drug Therapy, Combination; D004699:Endocardium / Q000473:pathology; D006082:Graft Enhancement, Immunologic; D006084:Graft Rejection / Q000517:prevention & control; D016027:Heart Transplantation / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000276:immunology*; D008213:Lymphocyte Activation / Q000187:drug effects*; D016853:Muromonab-CD3 / Q000494:pharmacology / Q000627:therapeutic use*; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D014019:Tissue Donors; D016896:Treatment Outcome; D015215:Zidovudine / Q000008:administration & dosage / Q000627:therapeutic use
D016853:Muromonab-CD3; D015215:Zidovudine; D016572:Cyclosporine; D011241:Prednisone