Parlevliet K J, ten Berge R J, Raasveld M H, Surachno J, Wilmink J M, Schellekens P T
Renal Transplant Unit, University of Amsterdam, The Netherlands.
Nephrol Dial Transplant. 1994;9(6):698-703. doi: 10.1093/ndt/9.6.698.
In a prospective clinical study we tested the immunosuppressive properties and toxicity of low-dose OKT3 induction therapy in renal transplant recipients. 50 consecutive renal transplant recipients were alternatingly assigned to low-dose OKT3 induction or prednisolone/cyclosporin. Low-dose OKT3 induction treatment consisted of 0.5 mg OKT3 twice daily for 10 days, initially combined with azathioprine and prednisolone maintenance immunosuppression that was converted to prednisolone/cyclosporin at the end of the course. During a 15-29-month follow-up period, low-dose OKT3 induction therapy was found to reduce significantly the incidence of acute rejections, as compared to the usual prednisolone/cyclosporin maintenance immunosuppression (21 versus 52%, P = 0.02). There also was a tendency towards an improved graft function after low-dose OKT3, although no significance was reached. Furthermore, compared to a historical control group of renal transplant patients in whom acute rejection was treated with 5 mg OKT3 daily, low-dose OKT3 appeared to cause fewer side-effects. We conclude that low-dose OKT3 induction therapy is superior to prednisolone/cyclosporin in preventing acute rejection after renal transplantation and that it is better tolerated than conventional OKT3 treatment.
在一项前瞻性临床研究中，我们测试了低剂量OKT3诱导疗法在肾移植受者中的免疫抑制特性和毒性。50名连续的肾移植受者被交替分配接受低剂量OKT3诱导治疗或泼尼松龙/环孢素治疗。低剂量OKT3诱导治疗包括每天两次给予0.5毫克OKT3，共10天，最初与硫唑嘌呤和泼尼松龙维持免疫抑制联合使用，疗程结束时转换为泼尼松龙/环孢素。在15至29个月的随访期内，发现与常规泼尼松龙/环孢素维持免疫抑制相比，低剂量OKT3诱导疗法显著降低了急性排斥反应的发生率（21%对52%，P = 0.02）。低剂量OKT3治疗后移植功能也有改善的趋势，尽管未达到显著水平。此外，与历史对照组（每日用5毫克OKT3治疗急性排斥反应的肾移植患者）相比，低剂量OKT3似乎引起的副作用更少。我们得出结论，低剂量OKT3诱导疗法在预防肾移植后急性排斥反应方面优于泼尼松龙/环孢素，并且其耐受性比传统OKT3治疗更好。
