Effect of OKT3 in XXXX -resistant renal transplant rejection.

@entity1 @entity1033 @entity799 @entity870 @entity134 @entity1800 @entity4540 @entity204
Between January 1, 1982, and November 1, 1986, 169 cadaver renal graft transplantations were performed at this hospital with CsA as induction therapy. OKT3 was not available in this period. Of these grafts, 15.9% were lost within 6 months, 10.7% from acute rejection (AR). Between November 1, 1986, and October 1, 1992, 483 cadaver renal graft transplantation were performed. Induction therapy included @entity870 and OKT3 was available. Of these grafts, 8.7% were lost inside 6 months, 3.1% from AR. Of these last 483 grafts, 113 received 125 courses of OKT3. Ten courses were prophylactic, and 115 courses in 103 @entity1 were for rejection resistant to @entity134 therapy (biopsy proven in all but 2 cases. Ninety-three percent of rejection episodes treated with OKT3 responded, at least initially. Graft survival in OKT3-treated @entity1 was 81%, 77%, and 76% at 6 months, 1 year, and 2 years, respectively. In contrast, graft survival in @entity134 -resistant rejection during the first period (without OKT3) was 59%, 57%, and 57% at these intervals. There were 8 infective @entity204 within 6 months in the 113 OKT3-treated @entity1 , compared with 2 in the 343 who did not receive OKT3 (P < 0.001). There were 7 viral @entity204 in the OKT3 group compared with none in those not receiving OKT3 (P < 0.001). Prophylaxis with oral @entity1033 and @entity799 was instituted in October 1990 in OKT3-treated @entity1 and @entity4540 use was increased. Since this change, no further viral @entity204 have occurred. OKT3 is a very effective antirejection agent, but its use is associated with an increased mortality from @entity1800 . With appropriate prophylaxis and treatment, however, this mortality can be reduced.
