OKT3治疗尸肾移植难治性排斥反应15例体会

目的 了解抗CD3单克隆抗体(OKT3)对肾移植难治性排斥反应的治疗效果和副作用。方法采用回顾性分析，对15例肾移植术后难治性排斥反应(其中加速排斥反应1例，急性排斥反应14例)应用OKT3治疗。结果1例加速排斥反应及14例急性排斥反应逆转，总逆转率为100％。应用OKT3后出现副作用：发热5例，寒战2例，呼吸困难2例，头痛4例，腹泻5例，白细胞下降3例。肺部感染5例，其中巨细胞病毒感染2例。结论难治性排斥反应使用OKT3治疗效果显著。细胞因子释放综合征是OKT3治疗的主要副作用，巨细胞病毒感染是OKT3治疗的严重并发症。

Clinical experience of treatment of 15 cases of refractory renal allograft rejection by OKT3

Objective To understand the curative effect and side effect of monoclonal antibody of anti CD3 (OKT3) in the treatment of refractory renal allograft rejection.Methods The OKT3 treatment of 15 cases of refractory renal allograft rejection (including one case of accelerated rejection and 14 cases of acute rejection) was studied retrospectively.Results One accelerated rejection and 14 acute rejection episodes were reversed. The reverse rate was 100%. Side effects of OKT3 were as follows: 5 cases of fever, 2 cases of chill, 2 cases of dyspnea, 4 cases of headache, 5 cases of diarrhea, 3 cases of leukocyte decrease, 5 cases of pulmonary infection (including 2 cases of cytomegalovirus infection). Conclusion OKT3 could effectively treat refractory renal allograft rejection.Cytokines release syndrome was the main side effects of treatment with OKT3 and cytomegalovirus infection was a very serious side effect of treatment with OKT3.