PMID: 2494022Apr 1, 1989Paper

The cardiopulmonary response to OKT3 in orthotopic cardiac transplant recipients

Chest
K L SteinJ Armitage

Abstract

Improvement in the outcome from cardiac transplantation can be attributed to recent advances in immunosuppression, including the use of OKT3, a new monoclonal antibody. The first dose of OKT3 induces side effects such as dyspnea in other transplant populations. We studied cardiopulmonary responses to OKT3 in 23 recipients of cardiac transplants. Despite pretreatment including antihistamines, hydrocortisone, and acetaminophen, OKT3 administered within 72 hours of transplantation, as part of prophylactic immunosuppression, induced a biphasic systemic response. Within the first hour, patients developed fever, hyperdynamia, hypertension, and tachycardia. By five to seven hours after the dose, there was mild hypotension, hypoxemia, and decreased indices of vascular resistance. Eighteen of the 23 patients required supplemental oxygen or vasopressor support (or both). Our findings define a complex cardiovascular response to OKT3 exhibited by the delayed noncoincident onset of hemodynamic instability, hypoxemia, and fever. Close observation in an ICU is recommended during the initial administration of OKT3 for prompt intervention when reactions occur.

References

Jun 9, 1988·The New England Journal of Medicine·H R MichieD W Wilmore
Aug 8, 1985·The New England Journal of Medicine·UNKNOWN Ortho Multicenter Transplant Study Group
Jan 1, 1987·Nephron·A B Cosimi
Feb 1, 1987·Transplantation·J R ThistlethwaiteF P Stuart
Jul 1, 1969·The Annals of Thoracic Surgery·D A CooleyR D Leachman

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Citations

Mar 12, 1999·The Surgical Clinics of North America·G V MazariegosD J Kramer
Mar 30, 2013·Seminars in Thrombosis and Hemostasis·Gregory J del Zoppo
Aug 19, 1993·The New England Journal of Medicine·A G TurpieJ Hirsh
Sep 1, 1995·The Journal of Toxicological Sciences·K Takahashi
Sep 1, 1991·The Journal of International Medical Research·C SpiekerK H Rahn

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