Abstract
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 0KT3 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 >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 <5%. Of the six grafts requiring repeat OKT3, five failed-re-treatment 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.
Original language | English (US) |
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Pages (from-to) | 86-91 |
Number of pages | 6 |
Journal | Journal of pediatric gastroenterology and nutrition |
Volume | 14 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1992 |
Keywords
- OKT3
- Pediatric liver transplantation
- Steroid resistant rejection
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Gastroenterology