ABSTRACT
This report evaluates the incidence of clinically significant HSV infection among 23 renal allograft recipients receiving OKT3 for treatment of steroid- or ALG-resistant acute rejection. No HSV infections occurred among the five HSV seronegative patients studied; three of 11 HSV seropositive patients (27%) treated with a ten-day course of low-dose acyclovir prophylaxis developed HSV infection. All three occurred after acyclovir was stopped. Five of six evaluable seropositive patients (83%) who did not receive acyclovir prophylaxis suffered HSV infection. We conclude that low-dose oral acyclovir may be effective in the prevention of HSV infection during OKT3 treatment of seropositive patients. Continuation of acyclovir prophylaxis for two to four weeks following the conclusion of OKT3 therapy may prevent occurrence of delayed infections.
Subject(s)
Acyclovir/therapeutic use , Antibodies, Monoclonal/therapeutic use , Herpes Simplex/prevention & control , Kidney Transplantation , Adult , Antibodies, Monoclonal/adverse effects , Clinical Trials as Topic , Female , Graft Rejection , Herpes Simplex/etiology , Humans , Male , Transplantation, HomologousSubject(s)
Ampicillin/therapeutic use , Cephalexin/therapeutic use , Kidney Transplantation , Urinary Tract Infections/drug therapy , Adult , Clinical Trials as Topic , Cyclosporins/therapeutic use , Female , Humans , Immunosuppression Therapy , Male , Prednisone/therapeutic use , Random Allocation , Urinary Tract Infections/prevention & controlSubject(s)
Azathioprine/administration & dosage , Cyclosporins/administration & dosage , Kidney Transplantation , Costs and Cost Analysis , Creatinine/blood , Drug Administration Schedule , Graft Rejection , Graft Survival , Humans , Immunosuppression Therapy/economics , Immunosuppression Therapy/methods , Kidney/physiology , Time FactorsSubject(s)
Anti-Arrhythmia Agents/blood , Tachycardia, Supraventricular/blood , Tachycardia/blood , Anti-Arrhythmia Agents/administration & dosage , Disopyramide/administration & dosage , Disopyramide/blood , Electric Stimulation , Electrophysiology , Humans , Procainamide/administration & dosage , Procainamide/blood , Quinidine/administration & dosage , Quinidine/blood , Tachycardia/etiology , Tachycardia/physiopathology , Tachycardia, Supraventricular/etiology , Tachycardia, Supraventricular/physiopathologyABSTRACT
A method for measuring pretransplant CsA levels to predict posttransplant pharmacokinetic behavior was studied in a total of seven pediatric patients. Comparison of drug levels and single-dose pharmacokinetic characteristics in the pretransplant and posttransplant study periods suggest that this method (1) is useful in predicting early posttransplant blood levels and beta-phase half-life; (2) may prevent early episodes of acute allograft rejection associated with subtherapeutic cyclosporine immunosuppression; and (3) may identify those patients who should not be empirically treated with only cyclosporine and prednisone in the early posttransplant period.