Rejection prophylaxis with murine monoclonal CD-3 antibody (OKT3): considerations for early hospital discharge.
Murine monoclonal CD-3 antibody (OKT3) is a significant new addition to the immunosuppressant armamentarium for treatment of heart transplant rejection. In the Utah Transplantation Affiliated Hospitals (UTAH) Cardiac Transplant Program, Salt Lake City, a broad experience with OKT3 has been acquired. Fifteen patients were treated for refractory rejection, whereas 68 patients were treated for early rejection prophylaxis therapy utilizing either 10- or 14-day protocols. To facilitate early hospital discharge, 12 patients were able to complete OKT3 therapy as outpatients. A retrospective review of length of initial hospital stay and clinical results revealed that patients who received OKT3 had an average hospital stay (+ standard deviation) of 17.1 days, and their 12-month survival was 96%. Patients who received antithymocyte globulin and/or steroids had an average stay of 27.4 days (p less than 0.05) and a 12-month survival of 93%. In conclusion, the possibility for reduced hospital stay and consequent cost reduction exists with the use of OKT3, especially when completion of therapy can be managed in an outpatient setting.
Herrick
C M
CM
UTAH Cardiac Transplant Program, University of Utah, Salt Lake City.
Mealey
P C
PC
Hagan
M E
ME
Holland
C S
CS
Volkman
A K
AK
Menlove
R L
RL
D000553:Ambulatory Care / Q000191:economics; D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D000954:Antigens, Surface / Q000276:immunology*; D000961:Antilymphocyte Serum / Q000009:adverse effects / Q000627:therapeutic use; D004341:Drug Evaluation; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007902:Length of Stay / Q000191:economics; D051379:Mice; D008875:Middle Aged; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology
D000911:Antibodies, Monoclonal; D000954:Antigens, Surface; D000961:Antilymphocyte Serum