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The fate of renal allografts treated with OKT3 for steroid-resistant rejection.

F. Veronese,L. F. Gonçalves,L. L. Vilarinho,V. S. Macedo,R. Manfro

Published 1999 in Transplantation Proceedings

ABSTRACT

WITH CURRENT immunosuppressive protocols, acute rejection occurs in 30 to 70% of kidney transplant recipients, and there are data suggesting that one or more acute rejection episodes may have detrimental effects in graft survival, both in the short and long term. It is also accepted that steroid-resistant rejection may carry a worse prognosis for reversal, and that even those grafts that are rescued with antilymphocyte therapies might be fated to a short survival. The monoclonal antibody OKT3 is used for the treatment of steroid-resistant rejection in 20 to 40% of kidney transplant recipients and the short-term reversal rates are around 80 to 90%. However, the fate of OKT3rescued kidneys is less well established. We analysed graft function and survival and patient survival, in the short and long term, in patients that never had an acute rejection episode, in those with acute rejection(s) treated with highdose steroids, and in patients in whom the corticosteroids were followed by OKT3 as rescue therapy for rejection.

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