Induction of thromboses within renal grafts by high-dose prophylactic OKT3.
Among 93 consecutive kidney-transplant patients who received prophylactic OKT3 10 mg/day for 2 weeks, 9 had intragraft thromboses within 2 weeks of transplantation. The thromboses were in graft artery in 1 patient and veins in 3. The other 5 had thromboses in glomerular capillaries and thrombotic microangiopathy similar to that of haemolytic-uraemic syndrome. All attempted treatments failed, and the 9 grafts had to be removed. The finding that plasma concentrations of prothrombin fragment 1 and 2 were higher 4 h after the first OKT3 dose in OKT3 recipients than in transplant patients who received other prophylaxis (mean 5.88 [SEM 0.76] vs 2.25 [0.59] nmol/l, p less than 0.01) confirms that OKT3 has procoagulant effects in vivo.
Department of Nephrology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Belgium.
D
D
Abramowicz
O
O
Pradier
A
A
Marchant
S
S
Florquin
L
L
De Pauw
P
P
Vereerstraeten
P
P
Kinnaert
J L
JL
Vanherweghem
M
M
Goldman
D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D016030:Kidney Transplantation; D016853:Muromonab-CD3 / Q000009:adverse effects* / Q000627:therapeutic use; D012078:Renal Artery Obstruction / Q000209:etiology; D012079:Renal Circulation / Q000187:drug effects; D012082:Renal Veins; D013927:Thrombosis / Q000209:etiology*
D016853:Muromonab-CD3