Prophylactic immunosuppression with anti-interleukin-2 receptor monoclonal antibody LO-Tact-1 versus OKT3 in liver allografting. A two-year follow-up study.
A prospective trial was conducted in 129 recipients of primary liver transplantation, to compare induction immunosuppression using triple drug therapy (cyclosporine, steroids, and azathioprine; group 1, n = 42), versus triple drug therapy with a 10-day course of OKT3 (group 2, n = 44) or of the anti-interleukin-2 receptor monoclonal antibody LO-Tact-1 (group 3, n = 43). Two-year actual patient survival rates were 64%, 79%, and 93% in groups 1, 2, and 3, respectively (1 vs. 2, NS; I vs. III, P = 0.003; 2 vs. 3, NS). Up to 2 years after transplantation, 18%, 44%, and 53% of the grafts in groups 1, 2, and 3, respectively, had not experienced steroid-resistant acute rejection (1 vs. 2, P = 0.002; 1 vs. 3, P = 0.007; 2 vs. 3, NS). The overall incidence of chronic rejection was 4%. OKT3 therapy, but not LO-Tact-1, significantly increased the incidence of cytomegalovirus infections (P = 0.019). In conclusion, immunoprophylaxis with LO-Tact-1 seemed to provide a liver graft acceptance rate at least as satisfactory as that with OKT3, without an increase in the incidence of infections.
Reding
R
R
Department of Surgery, University of Louvain Medical School, Brussels, Belgium.
Feyaerts
A
A
Vraux
H
H
Latinne
D
D
De La Parra
B
B
Cornet
A
A
Cormont
F
F
Jamart
J
J
Sokal
E
E
de Ville de Goyet
J
J
Lerut
J
J
Bazin
H
H
Otte
J B
JB
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003141:Communicable Diseases / Q000150:complications; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000379:methods*; D016031:Liver Transplantation / Q000276:immunology*; D016853:Muromonab-CD3 / Q000627:therapeutic use*; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000276:immunology*; D016019:Survival Analysis; D013997:Time Factors
D000911:Antibodies, Monoclonal; D016853:Muromonab-CD3; D015375:Receptors, Interleukin-2