Long-term outcome of the use of OKT3 to treat XXXX -resistant acute renal allograft rejection.

@entity1 @entity230 @entity134 @entity281 @entity1011 @entity2246
OKT3 was used to treat @entity134 -resistant acute renal allograft rejection in 30 of 496 adult @entity1 transplanted over a 6-year period. Rejection was reversed (defined as a fall in serum @entity1011 by 50% or more within 30 days of treatment with OKT3) in 40% of cases. Successful reversal was significantly more likely when rejection occurred shortly after transplantation (t ratio -2.53; P = 0.019). The long-term outcome was disappointing; the actuarial graft survival at 1 year from the start of treatment with OKT3 was 42%, and no grafts have thus far survived longer than 3 years. Graft survival was shorter in older @entity1 ( @entity2246 .226; P < 0.05), and no other predictor of long-term outcome was identified. @entity1 survival at 3 years was 88%. Serious @entity281 occurred in 33% of @entity1 , with two deaths. Our experience suggests that treatment with OKT3 is unlikely to reverse acute renal allograft rejection in more than half of @entity1 where rejection is resistant to @entity230 . Although long-term graft survival occurred in a few cases, the overall long-term outcome was disappointing, particularly in older @entity1 . Finally, our analysis indicates the difficulty of predicting which @entity1 will derive long-term benefit when OKT3 is used to treat @entity134 -resistant rejection.
