LOW-DOSE OKT3 INDUCTION THERAPY FOLLOWING RENAL-TRANSPLANTATION - A CONTROLLED-STUDY

In a prospective clinical study we tested the immunosuppressive proper ties and toxicity of low-dose OKT3 induction therapy in renal transpla nt recipients. 50 consecutive renal transplant recipients were alterna tingly assigned to low-dose OKT3 induction or prednisolone/cyclosporin . Low-dose OKT3 induction treatment consisted of 0.5 mg OKT3 twice dai ly for 10 days, initially combined with azathioprine and prednisolone maintenance immunosuppression that was converted to prednisolone/cyclo sporin at the end of the course. During a 15-29-month follow-up period , low-dose OKT3 induction therapy was found to reduce significantly th e incidence of acute rejections, as compared to the usual prednisolone /cyclosporin maintenance immunosuppression (21 versus 52%, P=0.02). Th ere also was a tendency towards an improved graft function after low-d ose OKT3, although no significance was reached. Furthermore, compared to a historical control group of renal transplant patients in whom acu te rejection was treated with 5 mg OKT3 daily, low-dose OKT3 appeared to cause fewer side-effects. We conclude that low-dose OKT3 induction therapy is superior to prednisolone/cyclosporin in preventing acute re jection after renal transplantation and that it is better tolerated th an conventional OKT3 treatment.