Antilymphocyte Antibodies, Renal Transplantation, and Meta-Analysis
Authors: Andrew S. Levey
Journal: Annals of Internal Medicine (1998)

Editorials15 May 1998Antilymphocyte Antibodies, Renal Transplantation, and Meta-AnalysisAndrew S. Levey, MD, Christopher H. Schmid, PhD, and Joseph Lau, MDAndrew S. Levey, MDNew England Medical Center; Boston, MA 02111Search for more papers by this author, Christopher H. Schmid, PhDNew England Medical Center; Boston, MA 02111Search for more papers by this author, and Joseph Lau, MDNew England Medical Center; Boston, MA 02111Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-10-199805150-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Antibodies directed against human lymphocytes are among the most potent immunosuppressive agents available for organ transplantation [1-6]. These biological preparations, referred to here as antilymphocyte antibodies, vary in the type of cell (lymphocyte, lymphoblast, thymocyte) used to induce the antibody response and the host (horse, rabbit, mouse-human hybridoma) in which the response is induced. When used to treat acute rejection, they improve graft survival. When used as induction therapy immediately after transplantation, they reduce the risk for acute rejection, but clinical trials have not shown them to have a beneficial effect on graft survival, in part because these trials did ...References1. Halloran PF. Immunosuppressive agents in clinical trials in transplantation. Am J Med Sci. 1997; 313:283-8. Google Scholar2. Wilde MI, Goa KL. Muromonab CD3: a reappraisal of its pharmacology and use as prophylaxis of solid organ transplant rejection. Drugs. 1996; 51:865-94. Google Scholar3. Bonnefoy-Berard N, Revillard JP. Mechanisms of immunosuppression induced by antithymocyte globulins and OKT3. J Heart Lung Transplant. 1996; 15:435-42. Google Scholar4. Suthanthiran M, Morris RE, Strom TB. Immunosuppressants: cellular and molecular mechanisms of action. Am J Kidney Dis. 1996; 28:159-72. Google Scholar5. Swinnen LJ, Costanzo-Nordin MR, Fisher SG, O'Sullivan EJ, Johnson MR, Heroux AL, et al. Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiactransplant recipients. N Engl J Med. 1990; 323:1723-8. Google Scholar6. Thistlethwaite JR Jr, Stuart JK, Mayes JT, Gaber AO, Woodle S, Buckingham MR, et al. Complications and monitoring of OKT3 therapy Am J Kidney Dis. 1988; 11:112-9. Google Scholar7. Szczech LA, Berlin JA, Aradhye S, Grossman RA, Feldman HA. Effect of anti-lymphocyte induction therapy on renal allograft survival: a meta-analysis. J Am Soc Nephrol. 1997; 8:1771-7. Google Scholar8. Szczech LA, Berlin JA, Feldman HA. The effect of antilymphocyte induction therapy on renal allograft survival. A meta-analysis of individual patient-level data. Ann Intern Med. 1998; 128:817-26. Google Scholar9. Systematic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Early Breast Cancer Trialists' Collaborative Study Group. Lancet. 1992; 339:1-15 Google Scholar10. Systematic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Early Breast Cancer Trialists' Collaborative Study Group. Lancet. 1992; 339:71-85. Google Scholar11. Chemotherapy in advanced ovarian cancer: an overview of randomised clinical trials. Advanced Ovarian Cancer Trialists Group. BMJ. 1991; 303:884-93. Google Scholar12. Oxman AD, Guyatt GH. A consumer's guide to subgroup analyses. Ann Intern Med. 1992; 116:78-84. Google Scholar13. Ioannidis JP, Lau J. The impact of high risk patients on the results of clinical trials. J Clin Epidemiol. 1997; 50:1089-98. Google Scholar14. Morgenstern H. Uses of ecologic analysis in epidemiologic research. Am J Public Health. 1982; 72:1336-44. Google Scholar15. Sim I. Trial Banks: An Informatics Foundation for Evidence-Based Medicine [doctoral dissertation]. Stanford, CA: Stanford University; December 1997. Report no. STAN-CS-TR-97-1599. Google Scholar Author, Article, and Disclosure InformationAuthors: Andrew S. Levey, MD; Christopher H. Schmid, PhD; Joseph Lau, MDAffiliations: New England Medical Center; Boston, MA 02111Corresponding Author: Andrew S. Levey, MD, New England Medical Center, Box 784, 750 Washington Street, Boston, MA 02111.Grant Support: In part by Agency for Health Care Policy and Research grants RO1 HS 07782 and RO1 HS 08532. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEfficacy and safety of single and multiple dose antithymocyte globulin induction treatment in living related renal transplantationSequential Protocols using Basiliximab versus Anti-Thymocyte Globulins in Renal-Transplant Patients Receiving Mycophenolate Mofetil and SteroidsImmunoprophylaxis with Basiliximab Compared with Antithymocyte Globulin in Renal Transplant Patients Receiving MMF-containing Triple TherapyAngiotensin-Converting Enzyme Inhibitors and Progression of Nondiabetic Renal Disease A Meta-Analysis of Patient-Level DataTazeen H. Jafar, MD, MPH, Christopher H. Schmid, PhD, Marcia Landa, MA, Ioannis Giatras, MD, Robert Toto, MD, Giuseppe Remuzzi, MD, Giuseppe Maschio, MD, Barry M. Brenner, MD, Annelise Kamper, MD, Pietro Zucchelli, MD, Gavin Becker, MD, Andres Himmelmann, MD, Kym Bannister, MD, Paul Landais, MD, Shahnaz Shahinfar, MD, Paul E. de Jong, MD, PhD, Dick de Zeeuw, MD, Joseph Lau, MD, and Andrew S. Levey, MD, and the ACE Inhibition in Progressive Renal Disease Study Group* 15 May 1998Volume 128, Issue 10Page: 863-865KeywordsAntibodiesAntibody therapyClinical trialsGraft survivalMedical risk factorsRandomized trialsRegression analysisRenal transplantationSurvival analysisTransplantation ePublished: 15 August 2000 Issue Published: 15 May 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...