OPTIMAL PERIOPERATIVE IMMUNOSUPPRESSION IN CARDIAC TRANSPLANTATION USING RABBIT ANTITHYMOCYTE GLOBULIN
| Autor: | Robert L. Hardesty, Yuji Miyamoto, Robert L. Kormos, John M. Armitage, Dummer Js, Griffith Bp |
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| Rok vydání: | 1990 |
| Předmět: |
Antigens
Differentiation T-Lymphocyte Graft Rejection medicine.medical_specialty CD3 Complex medicine.medical_treatment Receptors Antigen T-Cell chemical and pharmacologic phenomena Azathioprine Communicable Diseases Gastroenterology Prednisone Internal medicine medicine Humans Meningitis Prospective Studies Antilymphocyte Serum Immunosuppression Therapy Transplantation Chemotherapy business.industry Incidence (epidemiology) Antibodies Monoclonal Aseptic meningitis Immunosuppression Perioperative medicine.disease Survival Analysis Surgery Heart Transplantation business medicine.drug |
| Zdroj: | Transplantation. 49:306-310 |
| ISSN: | 0041-1337 |
| Popis: | A randomized trial of RATG (polyclonal) vs. OKT3 (monoclonal) antibody prophylaxis was carried out in 82 cardiac transplant recipients who, in addition, received baseline immunosuppression with cyclosporine, azathioprine and prednisone. One-year actuarial survival was comparable between groups (95% and 98%). The incidence of moderate or severe rejection within the first 30 days of transplant was over 7 times greater in patients receiving OKT3 vs. those receiving RATG. Patients receiving OKT3 were more likely to have repeated episodes of rejection and the mean time to rejection for patients receiving OKT3 was shorter (33 days) than for RATG patients (67 days). At 120 days, 52% of RATG patients were free of rejection while only 37% of the OKT3 patients were rejection-free. There was no difference in the incidence of major or minor bacterial or viral infection between groups. Patients receiving OKT3 showed a less-prolonged depression of the CD3 and CD4 T cell subsets than did those receiving RATG. Significant hemodynamic side-effects were seen after the first dose of OKT3 and there was a 5% incidence of aseptic meningitis associated with its use. |
| Databáze: | OpenAIRE |
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