肾移植后序贯使用OKT3和环孢素A进行排斥反应预防。

Rejection prophylaxis with sequential OKT3 and CSA after kidney transplantation.

作者信息

Weimar W, Hesse C J, Vaessen L M, Hendriks G F, Jutte N H, Jeekel J

机构信息

Department of Internal Medicine I, University Hospital Rotterdam, The Netherlands.

出版信息

Biotherapy. 1990;2(3):267-70. doi: 10.1007/BF02173528.

DOI:10.1007/BF02173528

PMID:1698424

Abstract

Sixteen kidney transplant recipients received the IgG2a anti-CD3 monoclonal antibody OKT3 and azathioprine as rejection prophylaxis during the first two postoperative weeks. Concomitant immunosuppression consisted of low dose steroids while cyclosporine A therapy was instituted on day 12. Side effects included fever, bronchospasm, hypotension and diarrhoea. OKT3 caused T cell modulation resulting in CD3 dim+, CD4+ or CD8+, CD5+, WT31- and 11F2- cells. Anti-OKT3 antibodies were found in approximately 50% of the patients. The protocol induced a 100% patient and graft survival and a 81% actuarial freedom of rejection at 18 months. It prevented CsA associated nephrotoxicity in the direct postoperative phase. These beneficial effects outweighed the side effects of OKT3.

摘要

16名肾移植受者在术后头两周接受了IgG2a抗CD3单克隆抗体OKT3和硫唑嘌呤预防排斥反应。同时免疫抑制包括低剂量类固醇，而环孢素A治疗在第12天开始。副作用包括发热、支气管痉挛、低血压和腹泻。OKT3导致T细胞调节，产生CD3 dim+、CD4+或CD8+、CD5+、WT31-和11F2-细胞。约50%的患者体内发现了抗OKT3抗体。该方案使患者和移植物存活率达到100%，18个月时排斥反应的实际无排斥率为81%。它在术后直接阶段预防了与环孢素A相关的肾毒性。这些有益效果超过了OKT3的副作用。