A prospective, double-blind, randomized study of high-versus low-dose OKT3 induction immunosuppression in cadaveric renal transplantation

Transplant International : Official Journal of the European Society for Organ Transplantation
D J NormanJ M Barry

Abstract

We undertook a prospective, double-blind study of high-(5-mg) versus low-(2-mg) dose OKT3 for induction immunosuppression (12 days) in cadaveric renal allograft transplantation. Maintenance immunosuppression was identical in both groups and consisted of azathioprine and prednisone initially, with cyclosporine beginning on the 5th postoperative day. Twenty-six patients were randomized. The groups were similar in terms of age, kidney ischemia time, peak PRA, and latest PRA. There were more diabetics and women in the high-dose group. Patient survival at 12 months was 100% in both groups. Graft survival at 12 months was 92% and 100% in the high- and low-dose groups, respectively. Infections were mostly minor and equal in frequency in the two groups. All patients receiving high- or low-dose OKT3 had manifestations of the cytokine release syndrome; these were delayed in onset in the low-dose group. Eleven patients (85%) in each group produced anti-OKT3 antibodies. Lymphocyte depletion after 1 day was major (> 98%) and identical in both groups. CD3 antigens were removed more slowly in the low-dose group but eventually at equal rates in both groups. Cost was significantly lower in the low-dose group. We conclude that while both doses o...Continue Reading

References

Aug 8, 1985·The New England Journal of Medicine·UNKNOWN Ortho Multicenter Transplant Study Group
Jan 1, 1987·Nephron·A B Cosimi

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Citations

Jan 1, 1996·Transplant International : Official Journal of the European Society for Organ Transplantation·C R DarbyJ R Salaman
Mar 21, 1998·Transplantation·J F WhitingD W Hanto
Jan 1, 1996·Transplant International : Official Journal of the European Society for Organ Transplantation·R WilliamsC Groth
Feb 5, 2002·Expert Opinion on Pharmacotherapy·B D Kahan
Aug 19, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Paolo CravediGiuseppe Remuzzi

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