Influence of low-dose cyclosporine on the outcome of treatment with OKT3 for acute renal allograft rejection

Transplantation
D E HricikJ A Schulak

Abstract

The outcomes of 51 consecutive patients who received OKT3 for acute renal allograft rejection were analyzed. Thirty patients (group 1), previously maintained on cyclosporine, continued to receive 50% of their maintenance dose of CsA during OKT3; 21 patients (group 2) either never received CsA or temporarily discontinued CsA during OKT3. All patients received low doses of azathioprine and prednisone during OKT3. Rejection was reversed by OKT3 in 90% of patients in group 1 and in 62% of patients in group 2. Continuation of CsA during OKT3 did not increase the incidence of serious infections following OKT3. Serum creatinine concentrations in groups 1 and 2 were comparable before, during, and after therapy with OKT3 suggesting that low doses of CsA do not induce graft dysfunction during therapy with the monoclonal antibody. In a subset of 22 prospectively studied patients, anti-OKT3 antibodies developed in 2 of 13 patients (15%) who continued low-dose CsA during OKT3 and in 6 of 9 patients (67%) in whom CsA was temporarily discontinued during OKT3. We conclude that administration of low doses of CsA during therapy with OKT3 may reduce the formation of anti-OKT3 antibodies without compromising reversal of rejection by the monoclonal...Continue Reading

Citations

Sep 1, 1992·Transplant International : Official Journal of the European Society for Organ Transplantation·K J Parlevliet, P T Schellekens
Jun 1, 1993·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·M MochonH J Baluarte
Oct 1, 1991·Current Opinion in Immunology·J Dantal, J P Soulillou
May 30, 2002·Transplantation Proceedings·R Loertscher
Dec 1, 1992·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·J M GrinoJ Alsina
Jun 28, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Charles CuvelierCharles van Ypersele de Strihou
May 1, 1990·The Journal of Pediatrics·M R LeoneG Goldstein
Sep 1, 1996·Journal of Transplant Coordination : Official Publication of the North American Transplant Coordinators Organization (NATCO)·S L Smith
Aug 3, 1992·The Medical Journal of Australia·G R Russ

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