Induction of thromboses within renal grafts by high-dose prophylactic OKT3

Lancet. 1992 Mar 28;339(8796):777-8. doi: 10.1016/0140-6736(92)91897-h.

Abstract

Among 93 consecutive kidney-transplant patients who received prophylactic OKT3 10 mg/day for 2 weeks, 9 had intragraft thromboses within 2 weeks of transplantation. The thromboses were in graft artery in 1 patient and veins in 3. The other 5 had thromboses in glomerular capillaries and thrombotic microangiopathy similar to that of haemolytic-uraemic syndrome. All attempted treatments failed, and the 9 grafts had to be removed. The finding that plasma concentrations of prothrombin fragment 1 and 2 were higher 4 h after the first OKT3 dose in OKT3 recipients than in transplant patients who received other prophylaxis (mean 5.88 [SEM 0.76] vs 2.25 [0.59] nmol/l, p less than 0.01) confirms that OKT3 has procoagulant effects in vivo.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Kidney Diseases / etiology*
  • Kidney Transplantation*
  • Muromonab-CD3 / adverse effects*
  • Muromonab-CD3 / therapeutic use
  • Renal Artery Obstruction / etiology
  • Renal Circulation / drug effects
  • Renal Veins
  • Thrombosis / etiology*

Substances

  • Muromonab-CD3