+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

OKT3 treatment of steroid-resistant rejection in pediatric liver transplant recipients

OKT3 treatment of steroid-resistant rejection in pediatric liver transplant recipients

Journal of Pediatric Gastroenterology and Nutrition 14(1): 86-91

Of a total of 187 consecutive liver grafts in 149 pediatric recipients, 59 episodes of steroid-resistant, biopsy-proven rejection (32% of grafts) were treated with OKT3 monoclonal antibody. After 59 OKT3-treated episodes, liver function at the end of treatment was normal in 40%, improved in 35%, and unchanged in 24%. Of 21 partial responses, 12 episodes eventually resolved to yield an overall complete response rate of 59%. CD3-positive T-cells greater than 5% occurred during 61% of OKT3-treated rejection episodes and was associated with impaired efficacy of OKT3 (30% complete response rate). Six grafts were re-treated with OKT3 for rejection and in all CD3-positive T-cells could not be maintained less than 5%. Of the six grafts requiring repeat OKT3, five failed-retreatment and required retransplantation. OKT3 antibodies of low titer were found prior to a second use of OKT3 in 65% of episodes. Patients treated with OKT3 after failing more than two preceding steroid courses had a significantly increased chance of graft loss (57%; p = 0.01). We conclude that this group of pediatric patients appeared less responsive to OKT3 compared to other series combining pediatric and adult recipients, possibly due to a more vigorous immune response in the child.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 040840788

Download citation: RISBibTeXText

PMID: 1315386

DOI: 10.1097/00005176-199201000-00016

Related references

Treatment of steroid-resistant rejection with tacrolimus prior to OKT3 in liver transplant recipients. Transplantation Proceedings 28(2): 1014, 1996

A comparison of outcomes between OKT3 and antithymocyte globulin for treatment of steroid-resistant rejection in hepatitis C liver transplant recipients. Transplantation 97(4): 470-473, 2014

Long-term results after primary successful FK 506 treatment of steroid- and OKT3-resistant rejection in renal transplant recipients. Transplantation Proceedings 29(7): 2955-2957, 1997

FK 506 in the treatment of steroid- and OKT3-resistant rejection in renal transplant recipients: reduced dosage and anti-infective prophylaxis. Transplantation Proceedings 28(6): 3166-3168, 1996

OKT3 monoclonal antibody treatment of steroid-resistant liver transplant rejection. Current Therapeutic Research. 55(4): 382-395, 1994

FK 506 is as effective as OKT3 for initial treatment for steroid resistant rejection in liver transplant patients. Hepatology 22(4 PART 2): 143A, 1995

A randomized prospective study comparing low-dose OKT3 to low-dose ATG for the treatment of acute steroid-resistant rejection episodes in kidney transplant recipients. Transplant International 11(3): 231-236, 1998

OKT3 for recipients with steroid-resistant acute rejection after liver transplantation. Zhonghua Gan Zang Bing Za Zhi 15(11): 857-858, 2007

OKT3 monoclonal antibody in pediatric kidney transplant recipients with recurrent and resistant allograft rejection. Journal of Pediatrics 111(1): 45-50, 1987

OKT3 monitoring in the treatment of steroid-resistant acute rejection of hepatotransplant recipients. European Journal Of Drug Metabolism & Pharmacokinetics. 23(2): 301-306, 1998

Basiliximab (Simulect) for the treatment of steroid-resistant rejection in pediatric liver transpland recipients: a preliminary experience. Transplantation 75(6): 796-799, 2003

A prospective study on the use of monoclonal anti-T3-cell antibody (OKT3) to treat steroid-resistant liver transplant rejection. Archives of Surgery 122(10): 1120-1123, 1987

The effect of induction alg malg on the outcome of steroid resistant rejection treatment with okt3 in renal transplant patients. Transplantation Proceedings 23(1 BOOK 2): 1039-1040, 1991

Tacrolimus for steroid- and OKT3-resistant rejection in kidney recipients. Transplantation Proceedings 30(4): 1251-1253, 1998

Early steroid-resistant rejection following orthotopic liver transplantation: new aspects of treatment with FK 506 instead of OKT3?. Transplantation Proceedings 25(4): 2693-2694, 1993