Cosimi A B, Jenkins R L, Rohrer R J, Delmonico F L, Hoffman M, Monaco A P
Transplantation Unit, Massachusetts General Hospital, Boston 02114.
Arch Surg. 1990 Jun;125(6):781-4; discussion 785. doi: 10.1001/archsurg.1990.01410180107017.
Seventy-nine hepatic allograft recipients were randomized to receive either conventional immunosuppression, including cyclosporine, azathioprine, and steroids (41 patients), or investigational therapy in which OKT3 replaced cyclosporine during the first postoperative week (38 patients). Early rejection occurred in 29 patients (71%) in the conventional group and 15 patients (39%) in the OKT3 group. Posttransplantation renal dysfunction occurred in 12 patients (29%) in the conventional group and 6 patients (16%) in the OKT3 group. Mean initial hospital stay was 34.1 +/- 18.8 days in the conventional group compared with 29.1 +/- 16.8 days in the OKT3 group. Cumulative patient survival (mean follow-up, 17.8 +/- 7.1 months) was 73.2% (30/41) for the conventional group and 84.2% (32/38) for the OKT3 group. Prophylactic OKT3 is indicated especially for liver allograft recipients with other complicating conditions that make management of early rejection unusually difficult.
79名肝移植受者被随机分为两组，一组接受包括环孢素、硫唑嘌呤和类固醇的传统免疫抑制治疗（41例患者），另一组接受试验性治疗，即在术后第一周用OKT3替代环孢素（38例患者）。传统组有29例患者（71%）发生早期排斥反应，OKT3组有15例患者（39%）发生早期排斥反应。传统组有12例患者（29%）发生移植后肾功能不全，OKT3组有6例患者（16%）发生移植后肾功能不全。传统组的平均初始住院时间为34.1±18.8天，而OKT3组为29.1±16.8天。传统组的累积患者生存率（平均随访时间为17.8±7.1个月）为73.2%（30/41），OKT3组为84.2%（32/38）。预防性使用OKT3尤其适用于患有其他复杂病症、早期排斥反应处理异常困难的肝移植受者。
