达利珠单抗和OKT3预防肾移植术后急性排斥反应的比较

Comparison of the efficacy of Simulect and OKT3 for prevention of acute renal allograft rejection

目的 比较达利珠单抗和OKT3预防肾移植术后早期急性排斥反应的效果。方法 肾移植受者在使用环孢素A(或他克莫司 )、霉酚酸酯及激素预防急性排斥反应的基础上加用达利珠单抗 (42例 )或OKT3(12 8例 ) ,观察 2个组肾移植术后 3个月内急性排斥反应发生率。结果 肾移植术后 3个月内 ,使用达利珠单抗者急性排斥反应发生率为 2 .4 % ,明显低于使用OKT3者的13.3% (P <0 .0 5 ) ,且前者无耐激素者 ,急性排斥反应的发生时间推迟 ,血肌酐恢复正常的时间也早于使用OKT3者。结论 达利珠单抗预防肾移植术后急性排斥反应的效果优于OKT3。

Objective To compare the clinical efficacy of Simulect and OKT3 for prevention of acute renal allograft rejection. Methods A total of 170 first cadaveric kidney transplant recipients were randomized to receive Simulect (Simulect group, n=42) or OKT3 (OKT3 group, n=128) subject to triple immunosuppression therapy (CsA/FK506, Cellcept and prednisone). The incidence of acute rejection was observed in both groups.Results Simulect group had less frequent incidence of acute rejection ( 2.4 % versus 13.2 %, P< 0.05) during the first 3 months after renal transplantation compared to OKT3 group. The 3-month person/graft survival rate in Simulect group and OKT3 group was 100 % and 99.2 %, respectively, with the difference being not statistical.Conclusion Simulect is an ideal immunosuppressive agent which is more effective for prevention of acute renal transplant allograft rejection than OKT3.