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PubMed1993

Antibody response to OKT3 and methods for monitoring.

Monitoring the antibody response to OKT3 is essential. Retreatment with OKT3 can be accomplished successfully in the great majority of patients. It is important to know the patient's peak antibody status before and during retreatment. Patients with no anti-OKT3 antibodies, or with low-titer (< or = 1:100) antibodies, especially if these do not include anti-idiotypic antibodies, have retreatment success similar to that of patients undergoing primary treatment with OKT3. In contrast, patients with high-titer (> or = 1:1000) antibodies should be treated with immunosuppression other than OKT3. Methods for monitoring the OKT3 antibody response have progressed, allowing one to estimate the titer and specificity (anti-idiotype and/or anti-isotype) in a timely fashion. Improvements still must be made in the area of standardization, so that results between various transplant centers can be more accurately compared.

Animals↗
PubMedDate not supplied

Does short-course induction with OKT3 improve outcome after heart transplantation? A randomized trial.

OKT3 is often used routinely for induction immunotherapy or selectively to avoid acute cyclosporine nephrotoxicity in heart transplant recipients at high risk for immediate postoperative kidney failure. It has not been shown in a randomized trial to be useful in patients at low risk for early kidney failure. We randomized 30 patients with a serum creatinine level of less than 1.4 mg/dl before heart transplantation to be treated with triple-drug immunotherapy with cyclosporine, which was started before surgery, (group 1) or to be treated with OKT3 for 4 to 6 days after surgery with oral cyclosporine, which was started between days 2 and 4, after renal function had stabilized (group 2). Follow-up for 6 months revealed no significant differences in the total number of rejection episodes, total number of infections, or in the serum creatinine level. Four patients in group 1 and five patients in group 2 have had no rejection. OKT3 showed a trend to delay time to first rejection (p = 0.10), as has been reported for the 14-day induction course of OKT3. A short course of OKT3 induction in heart transplant recipients at low risk for immediate postoperative kidney failure prolongs the time to first rejection for most patients but does not appear to reduce the total incidence of rejection in the first 6 months after heart transplantation.

Creatinine↗