A comparison of OKT3 monoclonal antibody and corticosteroids in the treatment of acute renal allograft rejection.
A comparison of OKT3 monoclonal antibody and corticosteroids in the treatment of acute renal allograft rejection.
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OKT3单克隆抗体与皮质类固醇治疗急性肾移植排斥反应的比较。
DOI：
10.1016/s0272-6386(88)80185-9
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发表时间：
1988
期刊：
影响因子：
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通讯作者：
Arnold G. Diethelm
中科院分区：
文献类型：
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作者：
M. Deierhoi;W. Barber;John J. Curtis;Bruce A. Julian;Robert G. Luke;S. Hudson;Bruce O. Barger;Arnold G. Diethelm
单克隆抗体OKT 3（Ortho Pharmaceutical，拉里坦，NJ）在两个单独的方案中用于治疗接受环孢素、硫唑嘌呤和泼尼松维持免疫抑制的患者的急性肾移植排斥反应。第一组54例患者接受类固醇激素治疗急性排斥反应，OKT 3用于耐药排斥反应和第二次排斥反应。在第二组中，34例患者接受OKT 3作为急性排斥反应的主要治疗，而类固醇用于抢救和第二次排斥反应。OKT 3成功地逆转了第二组82%的初始急性排斥反应，而第一组中类固醇逆转率为63%。仅15%的II组患者需要补救治疗，而I组患者为33%。类固醇主要治疗和OKT 3主要治疗的患者总生存率分别为96%和94%。3个月时同种异体移植物存活率相同，两组均为74%。基于同种异体移植物存活数据，OKT 3作为同种异体移植物排斥的主要治疗或在最初的皮质类固醇治疗失败的情况下作为补救治疗同样有效。
The monoclonal antibody OKT3 (Ortho Pharmaceutical, Raritan, NJ) was utilized in two separate protocols for treatment of acute renal allograft rejection in patients receiving cyclosporine, azathioprine, and prednisone for maintenance immunosuppression. In Group I, 54 patients received steroids for primary treatment of acute rejection with OKT3 used for resistant rejections and second rejection episodes. In Group II, 34 patients received OKT3 as primary treatment of acute rejection while steroids were used for rescue and second rejection episodes. OKT3 successfully reversed 82% of initial acute rejection episodes in Group II as compared with a 63% reversal with steroids in Group I. Rescue treatment was required in only 15% of Group II patients compared with 33% of Group I patients. Overall patient survival was 96% and 94%, respectively, for steroid primary and OKT3 primary treatments. Allograft survival at 3 months was identical, 74% in both groups. Based on allograft survival data, OKT3 is equally effective either as primary treatment for allograft rejection, or for rescue therapy if initial corticosteroid treatment fails.