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OKT3 and viral disease in pediatric liver transplant recipients

Bowman, JS and Green, M and Scantlebury, VP and Todo, S and Tzakis, A and Iwatsuki, S and Douglas, L and Starzl, TE (1991) OKT3 and viral disease in pediatric liver transplant recipients. Clinical Transplantation, 5 (4). 294 - 300. ISSN 0902-0063

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Abstract

Seventy-four consecutive pediatric liver transplant recipients were reviewed to assess the effect of the monoclonal anti-T-lymphocyte antibody OKT3 on subsequent viral infection (9 patients were excluded due to postoperative demise during the 1st week). Twenty-two patients received OKT3 in addition to standard cyclosporine-prednisone immunosuppression for either steroid-resistant acute rejection (18) or to facilitate reduction of cyclosporine due to severe renal impairment (4). Invasive infections were diagnosed by histology or culture in tissue biopsies or bronchoalveolar lavage specimens. The overall incidence of viral infection was 58%, half of which was due to cytomegalovirus (CMV). Invasive viral disease was associated with increased mortality (37% vs. 3% p = 0.001). Viral-related deaths were due to CMV (5), disseminated adenovirus (3), disseminated enterovirus (1) and respiratory syncytial viral pneumonia (1). The use of OKT3 was associated with increased viral disease (59% vs. 33% p = 0.04) and invasive primary CMV disease (58% vs. 19% p = 0.04). Trends were observed toward increased overall viral infection (73% vs. 51% p = 0.08), primary CMV infection (58% vs. 25% p = 0.08) and overall mortality (27% vs. 9% p = 0.08) following OKT3 therapy. We conclude that pediatric liver transplant recipients who require OKT3 therapy may be at increased risk for invasive viral disease and especially invasive primary CMV disease.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Bowman, JS
Green, M
Scantlebury, VP
Todo, S
Tzakis, A
Iwatsuki, S
Douglas, L
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1991
Date Type: Publication
Journal or Publication Title: Clinical Transplantation
Volume: 5
Number: 4
Page Range: 294 - 300
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0902-0063
Other ID: uls-drl:31735062117522, Starzl CV No. 1200
Date Deposited: 08 Apr 2010 17:20
Last Modified: 12 Oct 2017 08:57
URI: http://d-scholarship.pitt.edu/id/eprint/4586

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