Stephan R N, Munschauer C E, Kohli R K, Sridhar N R, Hoover E L, Davidson I J
Department of Nephrology, State University of New York at Buffalo School of Medicine and Biomedical Sciences and The Buffalo General Hospital, 14203, USA.
Transplantation. 1997 Apr 27;63(8):1183-6. doi: 10.1097/00007890-199704270-00021.
CD complex response to cessation of induction with OKT3 may be predictive of rejection. Twenty-seven patients receiving renal allografts and OKT3 induction immunosuppression were retrospectively analyzed for CD complex repopulation and allograft rejection. Flow cytometric monitoring was utilized in all patients. Responder status groups were identified based on CD complex repopulation, with fast responders demonstrating CD complex repopulation above the determined cohort mean. Slow responders had repopulation below this mean. Student's t test yielded P<0.01 (CD2), P<0.02 (CD3), and P<0.01 (CD8). Nonresponder patients were identified with repopulation below the mean, but flat compared with depletion. All nine fast responders lost their graft or were treated for rejection. No slow responder experienced graft loss or rejection episodes. One nonresponder was treated for rejection. CD complex activity following OKT3 cessation correlates with future rejection. Identification of responder status provides insight into propensity to reject, allowing individual tailoring of immunosuppression to patient response.
OKT3诱导治疗停止后CD复合物的反应可能预示着排斥反应。对27例接受肾移植并接受OKT3诱导免疫抑制的患者进行回顾性分析，以研究CD复合物的重新填充和移植肾排斥反应。所有患者均采用流式细胞术监测。根据CD复合物的重新填充情况确定反应者状态组，快速反应者的CD复合物重新填充高于确定的队列平均值，缓慢反应者的重新填充低于该平均值。学生t检验得出P<0.01（CD2）、P<0.02（CD3）和P<0.01（CD8）。无反应患者的重新填充低于平均值，但与耗竭相比无变化。所有9例快速反应者均失去移植肾或接受了排斥反应治疗。没有缓慢反应者经历移植肾丢失或排斥反应发作。1例无反应者接受了排斥反应治疗。OKT3停止后CD复合物活性与未来排斥反应相关。确定反应者状态有助于了解排斥倾向，从而根据患者反应对免疫抑制进行个体化调整。
