A randomized clinical trial of prophylactic OKT3 monoclonal antibody in liver allograft recipients.
Seventy-nine hepatic allograft recipients were randomized to receive either conventional immunosuppression, including cyclosporine, azathioprine, and steroids (41 patients), or investigational therapy in which OKT3 replaced cyclosporine during the first postoperative week (38 patients). Early rejection occurred in 29 patients (71%) in the conventional group and 15 patients (39%) in the OKT3 group. Posttransplantation renal dysfunction occurred in 12 patients (29%) in the conventional group and 6 patients (16%) in the OKT3 group. Mean initial hospital stay was 34.1 +/- 18.8 days in the conventional group compared with 29.1 +/- 16.8 days in the OKT3 group. Cumulative patient survival (mean follow-up, 17.8 +/- 7.1 months) was 73.2% (30/41) for the conventional group and 84.2% (32/38) for the OKT3 group. Prophylactic OKT3 is indicated especially for liver allograft recipients with other complicating conditions that make management of early rejection unusually difficult.
Cosimi
A B
AB
Transplantation Unit, Massachusetts General Hospital, Boston 02114.
Jenkins
R L
RL
Rohrer
R J
RJ
Delmonico
F L
FL
Hoffman
M
M
Monaco
A P
AP
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D002423:Cause of Death; D003524:Cyclosporins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000187:drug effects; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods* / Q000592:standards; D015994:Incidence; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016853:Muromonab-CD3; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation; D013256:Steroids / Q000627:therapeutic use; D015996:Survival Rate
D000911:Antibodies, Monoclonal; D003524:Cyclosporins; D016853:Muromonab-CD3; D013256:Steroids; D001379:Azathioprine