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John O. Colonna, II, MD; Leonard I. Goldstein, MD; John J. Brems, MD; Jorge H. Vargas, MD; Judith E. Brill, MD; William J. Berquist, MD; Jonathan R. Hiatt, MD; Ronald W. Busuttil, MD, PhD

Arch Surg. 1987;122(10):1120-1123.

Abstract
• Conventional treatment of acute liver allograft rejection has included high doses of corticosteroids and antithymocyte globulin. Urgent retransplantation was the only option for patients who failed to respond. We report our initial experience with the use of monoclonal anti—T3-cell antibody (OKT3) in 25 patients with acute hepatic allograft rejection that was resistant to steroid and/or antithymocyte globulin therapy. Twenty-four of 25 patients had a response to OKT3, which was complete in 14 and partial in ten. With a mean follow-up of 8.2 months, allograft salvage has been 80% and patient survival 88%; two patients underwent successful retransplantation. Side effects have been mild and well tolerated. Repeated rejection has occurred in 40% of patients, but these episodes have responded to steroid therapy. We conclude that OKT3 is well tolerated and highly effective in reversing severe episodes of acute hepatic allograft rejection that is resistant to highdose steroid therapy.

(Arch Surg 1987;122:1120-1123)

Author Affiliations
From the Departments of Surgery (Drs Colonna, Brems, Hiatt, and Busuttil), Medicine (Dr Goldstein), and Pediatrics (Drs Vargas, Brill, and Berquist), UCLA School of Medicine.

Footnotes
Accepted for publication June 16, 1987.

Read before the Annual Scientific Meeting of the Southern California Chapter of the American College of Surgeons, Santa Barbara, Calif, Jan 16, 1987.

Reprint requests to Room 77-132 CHS, UCLA Medical Center, 10833 LeConte Ave, Los Angeles, CA 90023 (Dr Busuttil).

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