OKT3 for the treatment of steroid-resistant acute renal allograft rejection

• Published in: Nephron (2015) Vol. 77; no. 3; p. 298
• Main Authors: Jogose, J T, Bailey, R R, Lynn, K L, Robson, R A, Wells, J E
• Format: Journal Article
• Language: English
• Published: Switzerland 1997
• Subjects: Adolescent; Adult; Aged; Drug Resistance; Female; Graft Rejection - immunology; Graft Rejection - mortality; Graft Rejection - therapy; Graft Survival - immunology; Humans; Kidney Transplantation - immunology; Male; Methylprednisolone - therapeutic use; Middle Aged; Muromonab-CD3 - adverse effects; Muromonab-CD3 - immunology; Muromonab-CD3 - therapeutic use; Steroids - therapeutic use
• ISSN: 1660-8151
• 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.