[Pulmonary complications from monoclonal antibody (OKT3) immunosuppression in patients who have undergone an orthotopic liver transplant].

Abstract

The authors investigated the incidence of pulmonary complications following immunosuppression with monoclonal antibodies (OKT3) in a series of 100 consecutive cases of orthotopic liver transplantation (OLT). Of 17 patients treated with OKT3 (16 for acute rejection and 1 for cyclosporine toxicity), 11 pulmonary infections were observed (65%), 9 of which (53%) with onset within a mean of 9 days after OKT3 administration. The infections were severe in all cases and lethal in 8 cases: the most common pathogens were Candida (4 cases) and Pseudomonas aeruginosa (3 cases). On the contrary, of 39 cases of rejection treated with steroids, infections were observed in 3 cases only (8%). The 53% incidence of pulmonary infections in OKT3 patients, significantly higher than in the extant patients (19%), confirms OKT3 treatment as a strong risk factor for severe pulmonary infections. Furthermore, the occurrence of pulmonary edema was directly related to OKT3 administration in 7 OKT3 patients (41%), whereas only 20 cases (24%) occurred in the extant OLT patients (p < 0.001). OKT3-related pulmonary edema was always observed in hyperhydrated patients at the time of drug administration and it seemed to be related to the vasoactive myocardiotoxic agents released by damaged T-cells.

• Authors: R Golfieri, E Giampalma, A Lalli, C Sama, N Venturoli, A Mazziotti, G Gozzetti, G Gavelli
• Journal: La Radiologia medica (Radiol Med) 1994 Jan-Feb Vol. 87 Issue 1-2 Pg. 58-64 ISSN: 0033-8362 [Print] Italy
• Vernacular Title: Complicanze polmonari da immunosoppressione con anticorpi monoclonali (OKT3) nei pazienti sottoposti a trapianto ortotopico di fegato.
• PMID: 8128034 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Muromonab-CD3

Topics

• Acute Disease
• Adolescent
• Adult
• Child
• Graft Rejection (diagnosis, epidemiology, etiology, prevention & control)
• Humans
• Immunosuppression Therapy (adverse effects, methods, statistics & numerical data)
• Incidence
• Italy (epidemiology)
• Liver Transplantation (statistics & numerical data)
• Lung Diseases (diagnosis, epidemiology, etiology)
• Middle Aged
• Muromonab-CD3 (administration & dosage, adverse effects)
• Postoperative Complications (diagnosis, epidemiology, etiology)
• Pulmonary Edema (diagnosis, epidemiology, etiology)
• Retrospective Studies