Fung J, Starzl T
Department of Surgery, University of Pittsburgh, Pennsylvania 15213.
Dig Dis Sci. 1991 Oct;36(10):1427-30. doi: 10.1007/BF01296810.
Liver rejection in the era of cyclosporine-based immunosuppression is approximately 60-70%. Approximately 15-25% of liver transplant patients will require hemodialysis following transplantation. These facts argue for a potent, less nephrotoxic immunosuppressive regimen, especially during the period of vulnerability to these events. Prophylactic use of OKT3 has been suggested as a means to decrease the need for hemodialysis while maintaining potent immunosuppression. The goal of this review is to examine potential benefits and pitfalls of this regimen. A lack of documentation of long-term patient and graft survival, the potential susceptibility to infectious complications, development of sensitization, and the cost must be weighed against the decreased need for hemodialysis and the control of early rejection episodes.
在基于环孢素的免疫抑制时代，肝移植排斥反应发生率约为60% - 70%。约15% - 25%的肝移植患者在移植后需要进行血液透析。这些事实表明需要一种强效且肾毒性较小的免疫抑制方案，尤其是在易发生这些情况的时期。有人建议预防性使用OKT3作为一种在维持强效免疫抑制的同时减少血液透析需求的方法。本综述的目的是研究该方案的潜在益处和缺陷。长期患者及移植物存活情况缺乏记录、对感染并发症的潜在易感性、致敏反应的发生以及成本等因素，必须与血液透析需求的减少和早期排斥反应的控制进行权衡。
