Comparison of Minnesota antilymphocyte globulin and OKT3 for induction of immunosuppression in renal transplant patients.

From May 1977 to April 1988, 88 patients receiving cadaveric kidney transplants were selected to receive Orthoclone (OKT3; 5 mg intravenous bolus) (n = 28) or Minnesota antilymphocyte globulin (MAG; 20 mg/kg/day) (n = 60) as the induction phase of a quadruple immunosuppressive protocol. The duration of treatment ranged from 5-16 days for OKT3 (mean, eight days) and 7-14 days for MAG (mean, nine days), as dictated by the post-operative recovery of renal function. All patients were followed for at least four months (maximum 16 months, mean 10 months). Of the 28 patients receiving OKT3, six (21%) had rejection episodes which wre reversed and did not reoccur. Two patients developed OKT3 antibody. Only one graft was lost to rejection. Of the 60 patients receiving MAG, 30 (50%) experienced a first rejection episode within the follow-up period; 15 of these had repeat rejections. Three allografts were subsequently lost in the MAG group. Renal function was significantly better in the OKT3 group. While both OKT3 and MAG were associated with excellent patient (98%) and graft (92%) survival, OKT3 was easier to administer with fewer rejection episodes. We conclude that OKT3 is superior to MAG as perioperative cytoreductive therapy following cadaveric kidney transplantation.