Wall W J, Ghent C N, Roy A, McAlister V C, Grant D R, Adams P C
Department of Surgery, University Hospital, London, Ontario, Canada.
Dig Dis Sci. 1995 Jan;40(1):52-7. doi: 10.1007/BF02063941.
This report details a single center's experience with OKT3 induction immunosuppression for liver transplantation. One hundred ninety-nine consecutive, unselected adult liver recipients received OKT3 therapy for 9-10 days combined with low-dose steroids and azathioprine. Cyclosporine was begun to overlap with the last few days of OKT3 therapy. The average dose of OKT3 was 45 mg. Fifty-two patients (26.1%) experienced 57 episodes of acute rejection. The median time of onset of rejection was 18 days after grafting. Seventy-eight percent of the rejection episodes were steroid-sensitive. Recurrent rejection was uncommon and the need for OKT3 retreatment was infrequent. One year actuarial graft and patient survival was 79.7% and 82.3% respectively. Based on this evidence, it appears that OKT3 prophylaxis provides good control of acute rejection with a very low incidence of recurrent rejection.
本报告详细介绍了单中心使用OKT3进行肝移植诱导免疫抑制的经验。199例连续入选的成年肝移植受者接受了9至10天的OKT3治疗，并联合小剂量类固醇和硫唑嘌呤。环孢素在OKT3治疗的最后几天开始重叠使用。OKT3的平均剂量为45毫克。52例患者（26.1%）发生了57次急性排斥反应。排斥反应的中位发生时间为移植后18天。78%的排斥反应对类固醇敏感。复发性排斥反应不常见，再次使用OKT3治疗的需求也很少。一年的移植和患者精算生存率分别为79.7%和82.3%。基于这些证据，OKT3预防似乎能很好地控制急性排斥反应，复发性排斥反应的发生率非常低。
