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A. Benedict Cosimi, MD; Roger L. Jenkins, MD; Richard J. Rohrer, MD; Francis L. Delmonico, MD; Mark Hoffman, MD; Anthony P. Monaco, MD

Arch Surg. 1990;125(6):781-785.

Abstract
• Seventy-nine hepatic allograft recipients were randomized to receive either conventional immunosuppression, including cyclosporine, azathioprine, and steroids (41 patients), or investigational therapy in which OKT3 replaced cyclosporine during the first postoperative week (38 patients). Early rejection occurred in 29 patients (71 %) in the conventional group and 15 patients (39%) in the OKT3 group. Posttransplantation renal dysfunction occurred in 12 patients (29%) in the conventional group and 6 patients (16%) in the OKT3 group. Mean initial hospital stay was 34.1 ±18.8 days in the conventional group compared with 29.1 ±16.8 days in the OKT3 group. Cumulative patient survival (mean follow-up, 17.8±7.1 months) was 73.2% (30/41) for the conventional group and 84.2% (32/38) for the OKT3 group. Prophylactic OKT3 is indicated especially for liver allograft recipients with other complicating conditions that make management of early rejection unusually difficult.

(Arch Surg. 1990;125:781-785)

Author Affiliations
From the Transplantation Unit, Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston (Drs Cosimi and Delmonico); Transplantation Service and Department of Surgery, New England Deaconess Hospital, Boston (Drs Jenkins and Monaco); and the Transplantation Service and Departments of Surgery and Medicine, Tufts–New England Medical Center, Boston (Drs Rohrer and Hoffman).

Footnotes
Accepted for publication February 3, 1990.

Read before the 70th Annual Meeting of the New England Surgical Society, Bretton Woods, NH, September 24, 1989.

Reprint requests to Department of Surgery, Massachusetts General Hospital, Boston, MA 02114 (Dr Cosimi).

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