A randomized trial of OKT3-based versus cyclosporine-based immunoprophylaxis after liver transplantation. Long-term results of a European and Australian multicenter study

Transplantation
O FargesH Bismuth

Abstract

A multicenter randomized trial was performed to compare two immunosuppressive protocols after first ABO-compatible liver transplantation. Forty six patients were randomized to a 14-day treatment with Orthoclone (OKT3) in association with steroids and azathioprine, cyclosporine being progressively introduced on day 11 posttransplant. Fifty patients were randomized to a standard protocol of cyclosporine with steroids and azathioprine. Minimum follow-up was 1 year and graft and patient survivals were updated for the purpose of the study. The cumulative 1-year incidence of acute rejection tended to be greater in the cyclosporine group (75%) than in the OKT3 group (67%), especially when patients who did not receive full-course treatment with OKT3 were excluded (59%). Renal function was better preserved during the first two postoperative weeks in the OKT3 group than in the control group but plasma creatinine levels were comparable in both groups thereafter. The incidence of severe infections was lower in the OKT3 group (13.6%) than in the cyclosporine group (32%). The 4-year incidences of patient and graft survival in the OKT3 group (69% and 61%, respectively) were not different from those in the cyclosporine group (62% versus 54%, r...Continue Reading

Citations

Sep 26, 2007·Transplantation·Ian SchreibmanArie Regev
Feb 5, 2010·Journal of Transplantation·Sandeep Mukherjee, Urmila Mukherjee
Jan 15, 2008·Journal of Autoimmunity·Michal AbrahamHoward L Weiner
Feb 19, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·John FungBijan Eghtesad
Mar 1, 2012·Pediatric Transplantation·Tracy CoelhoAnil Dhawan
Jul 26, 2005·Critical Reviews in Oncology/hematology·Anna L TaylorJ Andrew Bradley
Apr 29, 2015·Journal of Hepatology·David H AdamsDidier Samuel
Apr 1, 2017·The Cochrane Database of Systematic Reviews·Manuel Rodríguez-PerálvarezKurinchi Selvan Gurusamy
Feb 4, 2003·Nature Reviews. Immunology·Lucienne Chatenoud
Jun 6, 2014·The Cochrane Database of Systematic Reviews·Luit PenningaChristian Gluud
Jun 1, 2014·The Cochrane Database of Systematic Reviews·Luit PenningaChristian Gluud
Jan 25, 2020·The Cochrane Database of Systematic Reviews·Lawrence Mj BestKurinchi Selvan Gurusamy

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