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Initial experience with tacrolimus rescue therapy in OKT3 resistant rejection
S Herget1, U Heemann, J Friedrich
1Department of Nephrology, University Hospital, Essen, Germany.
Clinical Nephrology
|May 1, 1996
Summary
Tacrolimus (FK506) effectively treated acute renal allograft rejection unresponsive to steroids and OKT3 in 9 patients. While generally safe, it showed limited benefit for non-functioning kidneys and had minor side effects like increased infections.
Area of Science:
- Nephrology
- Transplantation Immunology
- Pharmacology
Background:
- Cyclosporin A is a standard immunosuppressant in renal transplantation.
- Intractable acute rejection poses a significant threat to graft survival.
- Tacrolimus (FK506) offers an alternative immunosuppressive strategy.
Purpose of the Study:
- To evaluate tacrolimus as rescue therapy for acute renal allograft rejection.
- To assess the efficacy and safety of converting from cyclosporin A to tacrolimus.
- To determine tacrolimus's impact on graft function and patient outcomes.
Main Methods:
- Follow-up study of 9 renal transplant recipients.
- Patients received cyclosporin A, then converted to tacrolimus for intractable rejection.
- Biopsies confirmed acute rejection; treatment response and adverse events were monitored.
Main Results:
- Six of nine patients achieved stable graft function after tacrolimus conversion.
- One patient lost the graft to chronic rejection; two with non-functioning kidneys remained on dialysis.
- Tacrolimus showed a manageable side effect profile, with slight increases in infection and hyperglycemia.
Conclusions:
- Tacrolimus is an effective rescue therapy for acute renal allograft rejection refractory to steroids and OKT3.
- Conversion to tacrolimus did not significantly increase complications.
- Tacrolimus therapy may not benefit renal transplant recipients with non-functioning kidneys.