Post-OKT3 induction therapy CD complex response predicts renal allograft rejection.
CD complex response to cessation of induction with OKT3 may be predictive of rejection. Twenty-seven patients receiving renal allografts and OKT3 induction immunosuppression were retrospectively analyzed for CD complex repopulation and allograft rejection. Flow cytometric monitoring was utilized in all patients. Responder status groups were identified based on CD complex repopulation, with fast responders demonstrating CD complex repopulation above the determined cohort mean. Slow responders had repopulation below this mean. Student's t test yielded P<0.01 (CD2), P<0.02 (CD3), and P<0.01 (CD8). Nonresponder patients were identified with repopulation below the mean, but flat compared with depletion. All nine fast responders lost their graft or were treated for rejection. No slow responder experienced graft loss or rejection episodes. One nonresponder was treated for rejection. CD complex activity following OKT3 cessation correlates with future rejection. Identification of responder status provides insight into propensity to reject, allowing individual tailoring of immunosuppression to patient response.
Stephan
R N
RN
Department of Nephrology, State University of New York at Buffalo School of Medicine and Biomedical Sciences and The Buffalo General Hospital, 14203, USA.
Munschauer
C E
CE
Kohli
R K
RK
Sridhar
N R
NR
Hoover
E L
EL
Davidson
I J
IJ
D000911:Antibodies, Monoclonal / Q000032:analysis; D000936:Antigen-Antibody Complex / Q000032:analysis*; D015703:Antigens, CD / Q000032:analysis / Q000276:immunology*; D000944:Antigens, Differentiation, B-Lymphocyte / Q000032:analysis / Q000276:immunology; D018801:CD2 Antigens / Q000032:analysis / Q000276:immunology; D017252:CD3 Complex / Q000032:analysis / Q000276:immunology*; D015704:CD4 Antigens / Q000032:analysis / Q000276:immunology; D016827:CD8 Antigens / Q000032:analysis / Q000276:immunology; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use; D006084:Graft Rejection / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D008213:Lymphocyte Activation; D016853:Muromonab-CD3 / Q000627:therapeutic use*; D011948:Receptors, Antigen, T-Cell / Q000276:immunology; D011990:Receptors, Transferrin; D013601:T-Lymphocytes / Q000276:immunology; D013997:Time Factors
D000911:Antibodies, Monoclonal; D000936:Antigen-Antibody Complex; D015703:Antigens, CD; D000944:Antigens, Differentiation, B-Lymphocyte; D018801:CD2 Antigens; D017252:CD3 Complex; D015704:CD4 Antigens; C068126:CD71 antigen; D016827:CD8 Antigens; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D011948:Receptors, Antigen, T-Cell; D011990:Receptors, Transferrin; D016572:Cyclosporine; D003404:Creatinine