CD3 monitoring and thymoglobulin therapy in cardiac transplantation: clinical outcomes and pharmacoeconomic implications.
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.
Uber
W E
WE
Department of Pharmacy, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Uber
L A
LA
VanBakel
A B
AB
Crumbley
A J
AJ
Pereira
N L
NL
Ikonomidis
J S
JS
Feldman
D S
DS
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
D015703:Antigens, CD; D000961:Antilymphocyte Serum; D017252:CD3 Complex; D007166:Immunosuppressive Agents