MOUSE ANTIBODY-COATED LYMPHOCYTES DURING OKT3 THERAPY IN LIVER-TRANSPLANTATION

Flow cytometry has been a technique in search of a use in transplantat ion. With each new monoclonal antibody, it has been hoped that the sec rets of rejection would be unlocked. The usefulness of CD3+ T-lymphocy te counts to predict successful treatment of organ transplant rejectio n has been called into question. CD2+, CD3+, and mouse anti-body-coate d CD3 lymphocytes were followed by flow cytometry in 44 liver transpla nt patients during OKT3 therapy for induction or rejection. CD3+ lymph ocyte counts did not predict successful management of rejection by OKT 3. When expressed as percentages of the total lymphocyte count, an inc reasing trend in CD2+ and mouse antibody-coated CD3+ lymphocytes after day 7 of OKT3 therapy portended persistent or recurrent rejection wit hin 2 months of treatment. It is uncertain if the increasing populatio n of mouse antibody-coated CD3 cells is due to an immune phenomen or d ecreased clearance by an ailing liver. Care should be taken when using CD3 lumphocyte counts as indicators of adequate OKT3 therapy in liver transplantation.