INDUCTION OF THROMBOSES WITHIN RENAL GRAFTS BY HIGH-DOSE PROPHYLACTICOKT3

Among 93 consecutive kidney-transplant patients who received prophylac tic OKT3 10 mg/day for 2 weeks, 9 had intragraft thromboses within 2 w eeks of transplantation. The thromboses were in graft artery in 1 pati ent and veins in 3. The other 5 had thromboses in glomerular capillari es and thrombotic microangiopathy similar to that of haemolyticuraemic syndrome. All attempted treatments failed, and the 9 grafts had to be removed. The finding that plasma concentrations of prothrombin fragme nt 1 and 2 were higher 4 h after the first OKT3 dose in OKT3 recipient s than in transplant patients who received other prophylaxis (mean 5.8 8 [SEM 0.76] vs 2.25 [0.59] nmol/l, p < 0.01) confirms that OKT3 has p rocoagulant effects in vivo.