Sequential therapy--a prospective randomized trial of MALG versus OKT3 for prophylactic immunosuppression in cadaver renal allograft recipients.
Sequential therapy--a prospective randomized trial of MALG versus OKT3 for prophylactic immunosuppression in cadaver renal allograft recipients.
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序贯治疗——MALG 与 OKT3 对尸体肾同种异体移植受者进行预防性免疫抑制的前瞻性随机试验。
DOI：
10.1097/00007890-199207000-00008
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发表时间：
1992
期刊：
影响因子：
6.2
通讯作者：
Najarian,JS
中科院分区：
文献类型：
--
作者：
Frey,DJ;Matas,AJ;Gillingham,KJ;Canafax,D;Payne,WD;Dunn,DL;Sutherland,DE;Najarian,JS
我们前瞻性研究了预防性明尼苏达抗淋巴细胞球蛋白与OKT 3在肾移植受者中的应用。在1987年7月1日至1990年9月1日之间，138例成人肾移植受者和35例肾-胰腺移植受者在按年龄（18-49岁vs. ≥ 50岁）、糖尿病（糖尿病vs.非糖尿病）、移植次数（1 vs. 1)以及，对于再次移植，第一次移植的存活时间（< 1年对≥ 1年），然后随机接受7天的MALG（20 mg/kg/天）或OKT 3（5 mg/天）。两组的免疫抑制在其他方面相同;泼尼松和硫唑嘌呤在手术当天开始，环孢素在术后第6天开始。最短随访时间为9个月。在一年和两年的精算患者或移植物存活率、排斥反应发生率或血清肌酐水平方面没有差异。MALG与巨细胞病毒感染有关，在CMV阴性受者中，MALG与巨细胞病毒感染有显著相关性（P<0.05）。05）。OKT 3更昂贵，并且与显着更多的副作用相关：发热（P<. 0001）、呼吸困难（P=.急性呼吸窘迫综合征（ARDS）组（P=. 04）。02）。
We prospectively studied the use of prophylactic Minnesota antilymphocyte globulin vs. OKT3 in kidney transplant recipients. Between 7/1/87 and 9/1/90, 138 adult kidney and 35 kidney-pancreas recipients were randomized after stratification for age (18–49 vs.≥ 50), diabetes (diabetic vs. nondiabetic), transplant number (1 vs.> 1) and, for retransplants, the length of survival of the first graft (< 1 year vs.≥ 1 year), and then randomized to receive 7 days of either MALG (20 mg/kg/day) or OKT3 (5 mg/day). Immunosuppression was otherwise identical in both groups; prednisone and azathioprine started on the day of surgery, and cyclosporine started on postoperative day 6. Minimum follow-up was 9 months. There was no difference in one-and two-year actuarial patient or graft survival rates, incidence of rejection, or serum creatinine level. MALG was associated with a higher incidence of cytomegalovirus; it was statistically significant in the subgroup of CMV seronegative recipients of kidneys from seropositive donors (P<. 05). OKT3 was more expensive and was associated with significantly more side effects: fever (P<. 0001), dyspnea (P=. 04), and acute respiratory distress syndrome (ARDS)(P=. 02).