Induction therapy in lung transplantation: a prospective, controlled clinical trial comparing OKT3, anti-thymocyte globulin, and daclizumab

Brock, Malcolm V.; Borja, Marvin C.; Ferber, Lawrence; Orens, Jonathan B.; Anzcek, Roberto A; Krishnan, Jerry A.; Su, Yang; Conte, John V.

doi:10.1016/s1053-2498(01)00356-4

Cited by 115 publications

(94 citation statements)

References 14 publications

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“…In lung transplant patients, BROCK et al [40] conducted a 4-yr prospective study enrolling 87 lung transplant recipients split into three groups: group 1 received OKT3, group 2 received ATG and group 3 received daclizumab. There was no difference in freedom from acute rejection or BOS at 2 yrs, and no difference in patient survival.…”

Section: Induction Therapymentioning

confidence: 99%

“…There was no difference in freedom from acute rejection or BOS at 2 yrs, and no difference in patient survival. Patients receiving OKT3 (n=30) had significantly more infections, mainly bacterial; this difference became significant only 2 months after transplantation [40]. GARRITY et al [41] retrospectively compared the incidence of acute rejection in 27 patients who received daclizumab induction therapy with the incidence of acute rejection in a historical control group of 34 patients receiving tacrolimus (Tac), Aza and steroids.…”

Section: Induction Therapymentioning

confidence: 99%

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Immunosuppressive therapy after human lung transplantation

Knoop¹,

Haverich²,

Fischer³

2004

European Respiratory Journal

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numbers of lung transplantation (LTx) were performed with or without induction therapy with antilymphocyte antibodies, monoclonal anti-CD3 antibody or anti-interleukin-2-receptor monoclonal antibodies. It remains to be established if induction therapy after LTx is beneficial or deleterious for long-term graft and patient survival.The vast majority of lung transplant recipients receive a triple-drug maintenance regimen including a calcineurin inhibitor, a cell-cycle inhibitor and steroids. Equal proportions receive cyclosporin A (CsA) and tacrolimus (Tac). There is also a trend to prescribe mycophenolate mofetil (MMF) instead of azathioprine (Aza). Steroid withdrawal is uncommon even 5 yrs after transplantation.The superiority of Tac over CsA as a maintenance agent has not been established to date, and the administration of MMF instead of Aza in combination with CsA and steroids did not improve graft or patient survival in a recent international, prospective, randomised, controlled trial.Shift from cyclosporin A to tacrolimus has emerged as the first treatment step of refractory acute rejection followed by high-dose steroids or antilymphocyte agents, total lymphoid irradiation or photopheresis. The treatment of chronic rejection remains deceptive and includes varied strategies such as modification of the maintenance regimen, addition of inhaled immunosuppressants and/or total lymphoid irradiation and photopheresis. Eur Respir J 2004; 23: 159-171.

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Section: Induction Therapymentioning

confidence: 99%

Section: Induction Therapymentioning

confidence: 99%

Immunosuppressive therapy after human lung transplantation

Knoop¹,

Haverich²,

Fischer³

2004

European Respiratory Journal

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“…[216][217][218] Muromonab has been used in non-FDA-approved indications for lung transplant rejection and prophylaxis, where the evidence supports a favorable outcome in these clinical situations. [216][217][218] Muromonab-CD3 is almost always used in combination with other immu nosuppressive agents. [216][217][218] Table 18 summarizes three studies in which toxicity information is available regarding muromonab.…”

Section: Muromonabmentioning

confidence: 99%

“…[216][217][218] Muromonab-CD3 is almost always used in combination with other immu nosuppressive agents. [216][217][218] Table 18 summarizes three studies in which toxicity information is available regarding muromonab. 171,219,220 3.3.3.1 Toxicity-According to Keay et al 221 and product information for Muromonab, 222 muromonab OKT3 is a signifi cant risk factor for symptomatic CMV infection ( P 5 .03).…”

Section: Muromonabmentioning

confidence: 99%

Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

Baughman

Meyer

Nathanson

et al. 2012

Chest

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Objectives: Immunosuppressive pharmacologic agents prescribed to patients with diffuse interstitial and infl ammatory lung disease and lung transplant recipients are associated with potential risks for adverse reactions. Strategies for minimizing such risks include administering these drugs according to established, safe protocols; monitoring to detect manifestations of toxicity; and patient education. Hence, an evidence-based guideline for physicians can improve safety and optimize the likelihood of a successful outcome. To maximize the likelihood that these agents will be used safely, the American College of Chest Physicians established a committee to examine the clinical evidence for the administration and monitoring of immunosuppressive drugs (with the exception of corticosteroids) to identify associated toxicities associated with each drug and appropriate protocols for monitoring these agents. Methods: Committee members developed and refi ned a series of questions about toxicities of immunosuppressives and current approaches to administration and monitoring. A systematic review was carried out by the American College of Chest Physicians. Committee members were supplied with this information and created this evidence-based guideline. Conclusions: It is hoped that these guidelines will improve patient safety when immunosuppressive drugs are given to lung transplant recipients and to patients with diffuse interstitial lung disease. CHEST 2012; 142(5):e1S-e111SAbbreviations: ACCP 5 American College of Chest Physicians; ALT 5 alanine aminotransferase; ATG 5 antithymocyte globulin; CHF 5 congestive heart failure; CMV 5 cytomegalovirus; CNI 5 calcineurin inhibitor; COI 5 confl ict of interest; CsA 5 cyclosporin A; FDA 5 US Food and Drug Administration; HBV 5 hepatitis B virus; HMG-CoA 5 b -hydroxy-bmethylglutaryl-coenzyme A; HSP 5 Health and Science Policy Committee; IL2RA 5 IL-2 receptor a ; ILD 5 interstitial lung disease; IPF 5 idiopathic pulmonary fi brosis; ITP 5 idiopathic thrombocytopenia purpura; LAM 5 lymphangioleiomyomatosis; MESNA 5 sodium 2-sulfonylethanesufonate; MPA 5 mycophenolic acid; mTOR 5 mammalian target of rapamycin; PTLD 5 posttransplant lymphoproliferative disease; RCT 5 randomized controlled trial; SIRS 5 systemic infl ammatory response syndrome; TNF 5 tumor necrosis factor; TPMT 5 thiopurine methyltransferase

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“…Induction therapy with either a cytolytic agent or an interleukin-2 receptor blocker has been shown to reduce early rejection rates [80]. Owing to the ease of administration, fewer side effects, similar efficacy and potentially fewer secondary infections, interleukin-2 receptor blockers are becoming the agents of choice for centres adhering to an induction protocol.…”

Section: Rejectionmentioning

confidence: 99%

Current status of lung transplantation

Lau¹,

Patterson²

2003

European Respiratory Journal

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Two decades have passed since the first successful clinical lung transplant was performed in 1983, and, in the interim, lung transplantation has become the preferred treatment option for a variety of end-stage pulmonary diseases. Remarkable progress has been made in the field through refinement of technique and improved understanding of transplant immunology and microbiology.Unfortunately, donor shortages continue to limit the more widespread application of lung transplantation. In order to address this issue, marginal donors, living lobar and split lung donor techniques, and nonheartbeating donors have been used clinically to increase the number of donor lungs available.Chronic rejection of the lung allograft is currently the major hurdle limiting longterm survival. To date, prevention of known risk factors and treatment strategies have not lessened the devastating toll this process has on lung transplant survival. Better understanding of the cause of chronic rejection is needed in order to develop novel strategies for its treatment. Promotion of immune tolerance is a promising area that could potentially eliminate chronic rejection.The present article discusses recent advances in lung transplantation. It also details the major issues facing the field today. Only through continued clinical and experimental investigation will lung transplantation eventually reach its full potential. Eur Respir J 2003; 22: Suppl. 47, 57s-64s.

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Induction therapy in lung transplantation: a prospective, controlled clinical trial comparing OKT3, anti-thymocyte globulin, and daclizumab

Cited by 115 publications

References 14 publications

Immunosuppressive therapy after human lung transplantation

Immunosuppressive therapy after human lung transplantation

Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

Current status of lung transplantation

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