title: CD3 monitoring and thymoglobulin therapy in cardiac transplantation: clinical outcomes and pharmacoeconomic implications.
abstract: BACKGROUND
  CD3 monitoring of antithymocyte globulin therapy in renal transplantation has been shown to be more cost-effective than standard regimens. The objective of this study was to evaluate CD3 monitoring with Thymoglobulin in cardiac transplantation.
  
  
  METHODS
  Cardiac transplant patients who required antithymocyte globulin therapy were dose-adjusted to maintain absolute CD3 counts <25 cells/microL. Endomyocardial biopsies and hemodynamic parameters were used to assess efficacy. The incidences of hematological side effects, opportunistic infections, and malignancies were recorded; in addition we performed a cost comparison.
  
  
  RESULTS
  Eight patients were treated with Thymoglobulin using CD3 monitoring to adjust the dosing. All patients responded with few side effects. Compared to standard dosing, CD3 monitoring allowed a 60% reduction in the average total dose and a 58% reduction in cost per patient.
  
  
  CONCLUSIONS
  CD3 monitoring of Thymoglobulin therapy in cardiac transplant patients results in lower doses and reduced costs with equivalent efficacy and a low incidence of complications.
authors.affiliation: Department of Pharmacy, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
authors.forename: W E
authors.initials: WE
authors.lastname: Uber
authors.forename: L A
authors.initials: LA
authors.lastname: Uber
authors.forename: A B
authors.initials: AB
authors.lastname: VanBakel
authors.forename: A J
authors.initials: AJ
authors.lastname: Crumbley
authors.forename: N L
authors.initials: NL
authors.lastname: Pereira
authors.forename: J S
authors.initials: JS
authors.lastname: Ikonomidis
authors.forename: D S
authors.initials: DS
authors.lastname: Feldman
mesh_terms: 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 / Q000379:methods; D005260:Female; D016027:Heart Transplantation / Q000191:economics / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013022:South Carolina; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD; D000961:Antilymphocyte Serum; D017252:CD3 Complex; D007166:Immunosuppressive Agents