CD3 monitoring of antithymocyte globulin therapy in thoracic organ transplantation.
BACKGROUND
Antithymocyte globulin is frequently used as a component of induction therapy in thoracic organ transplantation. This study evaluates the utility of monitoring peripheral CD3 lymphocytes to rationally adjust antithymocyte globulin therapy in this patient population.


METHODS
A total of 17 heart and 19 lung transplant recipients received antithymocyte globulin (ATGAM or thymoglobulin) as induction therapy or to treat steroid-resistant acute or chronic rejection. Absolute CD3 counts were maintained between 50 and 100 cells/microl.


RESULTS
With CD3 monitoring, the doses of antithymocyte globulin were reduced from 10-15 mg/kg to 1-5 mg/kg during the course of therapy. The total amount of antithymocyte globulin given to each CD3 monitored patient was reduced by 48%. Dose reduction did not alter the number of acute rejection or infectious episodes, and hematological side effects were infrequent.


CONCLUSIONS
CD3 monitoring of antithymocyte globulin therapy in thoracic organ recipients reduced the amount of drug received by each patient, while maintaining CD3 counts less than 100 cells/microl.
Krasinskas
Alyssa M
AM
Department of Pathology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA.
Kreisel
Daniel
D
Acker
Michael A
MA
Bavaria
Joseph E
JE
Pochettino
Alberto
A
Kotloff
Robert M
RM
Arcasoy
Selim
S
Blumenthal
Nancy
N
Kamoun
Malek
M
Moore
Jonni S
JS
Rosengard
Bruce R
BR
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood; D000961:Antilymphocyte Serum / Q000191:economics / Q000627:therapeutic use*; D017252:CD3 Complex / Q000097:blood*; D003365:Costs and Cost Analysis; D016903:Drug Monitoring; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D016027:Heart Transplantation / Q000191:economics / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use*; D016040:Lung Transplantation / Q000191:economics / Q000276:immunology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic; D015143:Philadelphia
D015703:Antigens, CD; D000961:Antilymphocyte Serum; D017252:CD3 Complex; D007166:Immunosuppressive Agents