OKT_3 治疗移植肾难治性排斥反应

OKT 3 treatment of refractory renal allograft rejection

为了解ＯＫＴ３对移植肾难治性排斥反应的治疗效果，１９９３年１月至１９９６年６月，我们对４４例肾移植术后移植肾难治性排斥反应（其中加速性排斥反应７例，急性排斥反应３７例）应用ＯＫＴ３治疗。结果：６例加速性排斥反应及３１例急性排斥反应逆转，总逆转率为８４．６％。２５例对ＯＫＴ３治疗产生迅速反应，平均逆转时间为７±４天，１２例发生延迟性反应，平均逆转时间为３４±３天（Ｐ＜０．０１）。作者认为：ＯＫＴ３治疗难治性排斥反应效果显著。巨细胞病毒感染及细胞因子释放综合征是ＯＫＴ３治疗的主要副作用。患者对ＯＫＴ３治疗的延迟性反应与细胞因子释放综合征及排斥损害有关。产生低滴度抗ＯＫＴ３抗体的患者可再次接受ＯＫＴ３治疗。

Between January 1993 and June 1996,44 episodes of refractory renal allograft rejection were treated with OKT 3 to understand the curative effect of OKT 3. Six of 7 accelerated and 31 of 37 acute rejection episodes were reversed. The reverse rate was 84 6%. Immediate response to OKT 3 was in 25 and delayed response in 12 patients. The mean reverse time was 7±4 days in immediate response and 34±3 days in delayed response ( P <0 01). It was claimed that OKT 3 had high effect in the treatment of refractory renal allograft rejection.Cytomegalovirus infection and cytokins release syndrome were the main side effect of treatment with OKT 3. The delayed response would be associated with cytokins release syndrome and damage of rejection.Patients with lower titre of anti OKT 3 antibodies could be retreated with OKT 3.