Document Detail


Prevention of acute rejection episodes with an anti-interleukin 2 receptor monoclonal antibody. I. Results after combined pancreas and kidney transplantation.
MedLine Citation:
PMID:  8310507     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A prospective, randomized trial was conducted to evaluate the short-term and long-term effects of induction immunosuppression with the rat IgG 2a monoclonal antibody 33B3.1, directed against the human alpha chain of the interleukin 2-receptor, following primary, cadaveric, combined pancreas and kidney transplantation. Forty patients were randomly assigned to receive 10 mg/day of 33B3.1 (n = 20) or 1.5 mg/kg/day of rabbit antithymocyte globulin (n = 20) for the first 10 postoperative days. Azathioprine, low-dose corticosteroids, and cyclosporine were given in association with either 33B3.1 or ATG. All 40 patients received the entire 10-day bioreagent course and no episode of rejection was observed during this period. Although the incidence of rejection did not significantly differ within the first, second, and third postoperative months (ten 33B3.1 and 6 ATG patients experienced, respectively, 10 and 6 rejection episodes within the first 3 months), the total number of 33B3.1 patients experiencing rejection throughout the follow-up was significantly higher than that of ATG (13 versus 6; P < 0.02). Immunological graft failure accounted for 2 pancreas and 2 kidney losses in the 33B3.1 group versus 1 in the ATG one (P = ns). The total number of infectious episodes was similar in both groups (21 versus 23). Two malignancies were observed in the ATG group (1 responsible for patient's death). One 33B3.1 patient died because of infectious pneumonia and 3 ATG patients died because of 2 cardiovascular diseases and 1 cancer. All patients had functioning grafts at the time of death. The 3-month and 36-month patient, pancreas, and kidney actuarial survival rates were, respectively, 100, 65, and 100%, and 95, 50, and 82% in the 33B3.1 group and 95, 80, and 90%, and 80, 70, and 80% in the ATG one (P = ns). These data suggest that, although a significantly higher rejection episode incidence was observed in patients treated with 33B3.1 monoclonal antibody as compared with ATG, similar long-term results can be obtained following primary cadaveric combined pancreas/kidney transplantation.
Authors:
D Cantarovich; B Le Mauff; M Hourmant; J Dantal; R Baatard; M Denis; Y Jacques; G Karam; J Paineau; J P Soulillou
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Transplantation     Volume:  57     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-03-16     Completed Date:  1994-03-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  198-203     Citation Subset:  IM    
Affiliation:
Service de Néphrologie et Immunologie Clinique, Unité INSERM U.211, Laboratoire de Biochimie, Centre Hospitalier et Universitaire de Nantes, France.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Antibodies, Monoclonal / therapeutic use*
Antilymphocyte Serum / administration & dosage
Diabetes Mellitus, Type 1 / surgery
Female
Follow-Up Studies
Graft Rejection / prevention & control*
Graft Survival
Humans
Immunosuppression
Kidney Transplantation* / physiology
Male
Middle Aged
Pancreas Transplantation* / physiology
Prospective Studies
Receptors, Interleukin-2 / immunology*
T-Lymphocytes / immunology
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antilymphocyte Serum; 0/Receptors, Interleukin-2

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