HDCN Article Review/Hyperlink

Abramowicz D, Norman DJ, Vereerstraeten P, Goldman M, et al

OKT3 prophylaxis in renal grafts with prolonged cold ischemia times: Association with improvement in long-term survival

Kidney Int (Mar) 49:768-772 1996

Results from two trials of the use of OKT3 as induction therapy in cadaveric renal transplantation were combined and analyzed to determine the effect of OKT3 on long-term graft survival. All patients received azathioprine and steroids. The control group received cyclosporine from the time of transplant, whereas the OKT3 group received OKT3 for 14 days after transplantation with cyclosporine being started on postoperative day 11. In patients with cold ischemia time greater than 24 hours, OKT3 resulted in fewer rejections in the first year (0.87 vs 1.35) and greater 2 year graft survival (84 vs 64 %) and 5 year graft survival (71 vs 56 %). Significant differences were not seen when cold ischemia time was less than 24 hours. The mechanism of this important benefit of OKT3 induction therapy when cold ischemia time was greater than 24 hours was not studied. (Mark S. Paller, M.D., University of Minnesota)