OKT3 therapy in addition to tacrolimus is associated with improved long-term function in patients with steroid refractory renal allograft rejection

Daniel Patschan, Andreas Kribben, Frank Pietruck, Jens Lutz, Matthias Binek, Thomas Philipp, Uwe Heemann, Oliver Witzke

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background/Aims: The aim of this study was to evaluate long-term allograft salvage rates of patients with steroid refractory allograft rejection after kidney transplantation and to identify factors indicating a successful outcome. Patients and Methods: Fifty patients with continuing rejection after high-dose steroids were included in the study. Baseline immunosuppression was switched from cyclosporine to tacrolimus in all patients. Twenty patients additionally received OKT3 as antirejection therapy. Patients having received a cadaveric renal transplant in 1995, excluding patients with steroid resistant rejection, were chosen as a control cohort. Results: Patient survival rates were 96% (n = 48) and 90% (n = 45) and allograft survival rates were 66% (n = 33) and 62% (n = 31) after 5 and 7 years following steroid refractory renal allograft rejection. Graft survival within the control cohort was 73% after 5 years and 69% after 7 years. Creatinine clearance increased from 20 ± 15 ml/min/1.73 m 2 at the start of tacrolimus therapy to 37 ± 29 ml/min/1.73 m 2 and to 32 ± 26 ml/min/1.73 m 2 after 5 and 7 years. OKT3 treatment predicted successful rescue therapy (p = 0.005 and p = 0.04 after 5 and 7 years). Conclusion: Our data indicate a reasonable graft survival in steroid refractory renal allograft rejection using tacrolimus. OKT3 treatment in addition to tacrolimus therapy may be beneficial for long-term allograft survival.

Original languageEnglish
Pages (from-to)c94-c99
JournalNephron - Clinical Practice
Volume103
Issue number3
DOIs
StatePublished - Jun 2006
Externally publishedYes

Keywords

  • OKT3
  • Renal transplantation
  • Steroid refractory rejection
  • Tacrolimus

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