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  • 1
    Electronic Resource
    Electronic Resource
    Rejection prophylaxis with sequential OKT3 and CSA after kidney transplantation (1990)
    Springer
    Biotherapy 2 (1990), S. 267-270 
    Details
    ISSN: 1573-8280
    Keywords: kidney transplantation ; OKT3 ; rejection prophylaxis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixteen kidney transplant recipients received the IgG2a anti-CD3 monoclonal antibody OKT3 and azathioprine as rejection prophylaxis during the first two postoperative weeks. Concomitant immunosuppression consisted of low dose steroids while cyclosporine A therapy was instituted on day 12. Side effects included fever, bronchospasm, hypotension and diarrhoea. OKT3 caused T cell modulation resulting in CD3 dim +, CD4+ or CD8+, CD5+, WT31− and 11F2−cells. Anti-OKT3 antibodies were found in approximately 50% of the patients. The protocol induced a 100% patient and graft survival and a 81% actuarial freedom of rejection at 18 months. It prevented CsA associated nephrotoxicity in the direct postoperative phase. These beneficial effects outweighed the side effects of OKT3.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02173528
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Mycophenolic acid trough levels after kidney transplantation in a cyclosporine-free protocol (2000)
    Springer
    Transplant international 13 (2000), S. S333 
    Details
    ISSN: 1432-2277
    Keywords: Key words Mycophenolate mofetil ; Mycophenolic acid ; Therapeutic drug monitoring ; Kidney transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Twenty-seven stable kidney transplant recipients treated with cyclosporine and prednisone were converted to mycophenolate mofetil (MMF) and prednisone 1 year after transplantation. After conversion the patients were treated with a standard daily dose of 1 g MMF b. i. d. and 10 mg prednisone for 4 months. Thereafter, two MMF dose reductions were performed with a 4-month interval. Mycophenolic acid (MPA) trough levels were measured at regular intervals. A relation was found between MPA trough levels and MMF dose. The median MPA trough level for patients treated with 1 g MMF b. i. d. was 4.3 μg/ml (0.95–15.5) and 3.0 μg/ml (0.73–7.8) for patients treated with 750 mg b. i. d. (P = 0.0002). The MPA trough levels further decreased from 3.0 to 2.3 μg/ml (0.6–6.63) in patients treated with 500 mg MMF b. i. d. (P = 0.01). Dose reduction of MMF from 1 g to 750 mg b. i. d. could be performed without acute rejections. A further dose reduction to 500 mg b. i. d. elicited 3 rejections. Patients experiencing an acute rejection had a median MPA trough level of 2.3 μg/ml (1.26–3.38) compared to 3.8 μg/ml (1.48–6.52) in patients without an acute rejection (P = 0.25). We conclude that there is a significant relation between MPA trough levels and MMF dose. MPA trough levels were not predictive of rejection in the present study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050355
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The TNF-α system after successful living-related kidney transplantation (1998)
    Springer
    Transplant international 11 (1998), S. S46 
    Details
    ISSN: 1432-2277
    Keywords: Key words TNF-α ; Soluble TNF receptors ; Living-related ; Kidney transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The TNF-α system is thought to play a central role in the reduced immunity of haemodialysis patients. The imbalance between the high levels of soluble TNF receptors R 1 and R 2 and the low levels of immunoactive TNF-α results in an increased TNF-α buffering capacity leading to reduced immune responses. Apart from impaired renal clearance of the receptors, inefficient TNF-α production as a result of the uraemia may also contribute to the imbalance between this cytokine and its receptors. In patients receiving a living-related kidney transplant, renal function is nearly normalized in a very short period. This restoration of renal function may result in a state of better immunocompetence, either as a result of improved clearance of the receptors or as a result of reversal of the uraemic state. To differentiate between these two possibilities, we measured TNF-α protein, mRNA and the soluble TNF receptors R 1 and R 2 before and after successful renal transplantation. TNF-α mRNA was not affected by transplantation, indicating constant TNF-α production. The imbalance in the TNF-α system was markedly improved after transplantation, although normal values of the soluble receptors were not reached. One year after transplantation in stable kidney transplant recipients there was still an imbalance in the TNF-α system caused by persistently elevated levels of the soluble TNF-receptors. These results suggest that even after successful kidney transplantation the TNF-α system remains activated. However, despite immunosuppressive therapy, recipients of a living-related kidney do have a better balanced TNF-α system compared to haemodialysis patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050424
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Single-shot, high-dose rabbit ATG for rejection prophylaxis after kidney transplantation (1993)
    Springer
    Transplant international 6 (1993), S. 337-340 
    Details
    ISSN: 1432-2277
    Keywords: Kidney transplantation, ATG ; ATG, single shot kidney transplantation ; Rejection, single shot ATG ; Single shot ATG, kidney transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the effects of a single intravenous injection of rabbit ATG (RIVM, Bilthoven, The Netherlands) in a dose of 8 mg/kg body weight administered 6 h after kidney transplantation on graft survival, rejection incidence, T-cell subsets, and cost-effectiveness. A total of 58 (37 male/21 female) consecutive renal allograft recipients were entered in this trial. Treatment results were compared with 56 patients treated with intravenous cyclosporin (CyA). In all patients concomitant medication consisted of steroids and azathioprine, followed by oral CyA. Following rabbit ATG, T cells (WT31) quickly disappeared from the peripheral blood and a return to greater than 100/mm3 was observed at a median of 7 (range 3–21) days. Graft survival was the same in both groups, as was the incidence of primary nonfunction. The rate of acute rejection was significantly lower in the rabbit ATG-treated patients (12% vs 50%). We conclude that a single shot of rabbit ATG is an attractive, easy, and cost-effective induction scheme with a low incidence of delayed graft function and acute rejection episodes. A relatively high incidence of vascular thrombosis of the graft, however, warrants further study before this treatment regimen can be generally applied.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00335971
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    Paper (German National Licenses)
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