High or low-dose steroid-therapy for acute renal-transplant rejection after prophylactic okt3 treatment : a prospective randomized study
Faculty of Medicine and Health Sciences
New york :Springer verlag
Transplant international. - Heidelberg, 1988
5TH CONGRESS OF THE EUROPEAN SOC FOR ORGAN TRANSPLANTATION, OCT 07-10, 1991, MAASTRICHT, NETHERLANDS
, p. S437-S439
In this prospective randomized study, acute renal transplant rejections occurring in patients who received prophylactic OKT3 therapy were treated with either 3 pulses of 8 mg/kg methylprednisolone (MPS) in an alternate-day regimen (total dose 25 mg/kg in 1 week, H group, n = 24) or 5 daily pulses of 3 mg/kg MPS (total dose 17 mg/kg, L group, n = 22). Acute rejection was proven by biopsy in more than 85 % of cases in both groups. No difference was observed in rejection reversal (H 88 %, L 91 %), graft losses in the following 3 months (H 11 %, L 4%) or the time evolution of the serum creatinine levels. The number (H 14, L 21) as well as the nature and severity of infections were similar in both groups. Only one death occurred in a patient who received OKT3 rescue therapy for corticoresistant rejections and developed Epstein-Barr virus (EBV)-related lymphoma. In conclusion, low dose MPS pulses appear as effective and safe as a higher dose to reverse acute rejection occurring after OKT3 prophylaxis. Thus, we favour the use of the low dose regimen in these patients.