Reduced dose OKT3 prophylaxis in sensitised kidney recipients

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Abstract
Prophylactic use of the monoclonal antibody OKT3 has been studied for the prevention of rejection in sensitised renal transplant recipients. Patients receiving a full dose (FD) regimen were compared to a subsequent consecutive group of patients receiving a reduced dose (RD) regimen. The characteristics of the two groups were not significantly different with regard to age, HLA mismatch and panel-reactive antibody (PRA) status. The number of days that OKT3 was given was 12.9 +/- 1.8 for the FD regimen and 11.3 +/- 2.8 for the RD regimen. The total dose of OKT3 given was 64.4 +/- 9 mg (FD) and 38.3 +/- 8.5 mg (RD). Patient survival at 12 months was 8/8 for FD and 17/17 for RD. Graft survival at 12 months was 7/8 for FD and 17/17 for RD. Creatinine at 24 months was 185 +/- 68 and 201 +/- 81 mumol/l for FD and RD, respectively. A reduced dose regimen of OKT3 produced excellent and comparable results to the standard recommended full-dose regimen. The cost per patient was reduced 40% from 5676 pounds for FD to 3344 pounds for RD.