Rejection prophylaxis with sequential OKT3 and CSA after kidney transplantation |
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Authors: | W Weimar C J Hesse L M B Vaessen G F J Hendriks N H P M Jutte J Jeekel |
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Institution: | (1) Departments of Internal Medicine I and General Surgery, University Hospital Rotterdam-Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands |
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Abstract: | Sixteen kidney transplant recipients received the IgG2a anti-CD3 monoclonal antibody OKT3 and azathioprine as rejection prophylaxis during the first two postoperative weeks. Concomitant immunosuppression consisted of low dose steroids while cyclosporine A therapy was instituted on day 12. Side effects included fever, bronchospasm, hypotension and diarrhoea. OKT3 caused T cell modulation resulting in CD3 dim +, CD4+ or CD8+, CD5+, WT31– and 11F2–cells. Anti-OKT3 antibodies were found in approximately 50% of the patients. The protocol induced a 100% patient and graft survival and a 81% actuarial freedom of rejection at 18 months. It prevented CsA associated nephrotoxicity in the direct postoperative phase.These beneficial effects outweighed the side effects of OKT3. |
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Keywords: | kidney transplantation OKT3 rejection prophylaxis |
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