Jogose J T, Bailey R R, Lynn K L, Robson R A, Wells J E
Department of Nephrology, Christchurch Hospital, New Zealand.
Nephron. 1997;77(3):298-303. doi: 10.1159/000190291.
OKT3 (Orthoclone) was first used in this unit on February 25, 1987. Up until March 31, 1996, 153 patients had a total of 163 transplants. Fifty of these patients who received 53 transplants (28 male, mean age 37.5 years, 48 cadaveric donors), were treated with OKT3 for steroid-resistant acute rejection. Forty-nine graft biopsies were undertaken and 47 showed acute rejection. In the other 4 episodes a clear-cut clinical and laboratory diagnosis of severe rejection was made. OKT3 (5 mg i.v.) was started at a median of 19 days following transplantation and was successful in reversing 43 of 51 (84%) episodes of steroid-resistant acute rejection. Of those treated, the patient and graft survival at 1 year was 86 and 69%, at 3 years 82 and 64% and at 5 years 79 and 61%, respectively. Adverse effects were common. Four patients died from sepsis within the first 3 months after transplantation. OKT3 was effective in reversing 84% of steroid-resistant acute rejection episodes.
OKT3（Orthoclone）于1987年2月25日首次在本单位使用。截至1996年3月31日，153例患者共进行了163次移植。其中50例接受了53次移植的患者（28例男性，平均年龄37.5岁，48例尸体供体），因激素抵抗性急性排斥反应接受了OKT3治疗。进行了49次移植肾活检，47次显示急性排斥反应。在其他4例中，根据临床和实验室检查明确诊断为严重排斥反应。OKT3（5毫克静脉注射）在移植后中位数19天开始使用，成功逆转了51例激素抵抗性急性排斥反应中的43例（84%）。在接受治疗的患者中，1年时患者和移植肾存活率分别为86%和69%，3年时为82%和64%，5年时为79%和61%。不良反应很常见。4例患者在移植后前3个月内因败血症死亡。OKT3能有效逆转84%的激素抵抗性急性排斥反应。
