OKT3 for the treatment of steroid-resistant acute renal allograft rejection.
OKT3 (Orthoclone) was first used in this unit on February 25, 1987. Up until March 31, 1996, 153 patients had a total of 163 transplants. Fifty of these patients who received 53 transplants (28 male, mean age 37.5 years, 48 cadaveric donors), were treated with OKT3 for steroid-resistant acute rejection. Forty-nine graft biopsies were undertaken and 47 showed acute rejection. In the other 4 episodes a clear-cut clinical and laboratory diagnosis of severe rejection was made. OKT3 (5 mg i.v.) was started at a median of 19 days following transplantation and was successful in reversing 43 of 51 (84%) episodes of steroid-resistant acute rejection. Of those treated, the patient and graft survival at 1 year was 86 and 69%, at 3 years 82 and 64% and at 5 years 79 and 61%, respectively. Adverse effects were common. Four patients died from sepsis within the first 3 months after transplantation. OKT3 was effective in reversing 84% of steroid-resistant acute rejection episodes.
Jogose
J T
JT
Department of Nephrology, Christchurch Hospital, New Zealand.
Bailey
R R
RR
Lynn
K L
KL
Robson
R A
RA
Wells
J E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D004351:Drug Resistance; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D016853:Muromonab-CD3 / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D013256:Steroids / Q000627:therapeutic use
D016853:Muromonab-CD3; D013256:Steroids; D008775:Methylprednisolone