Activation of Coagulation and Fibrinolysis Following OKT3 Administration to Renal Transplant Recipients: Association with Distinct Mediators

Maarten H M Raasveld; C Erik Hack; Ineke J M ten Berge

doi:10.1055/s-0038-1656362

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1992; 68(03): 264-267
DOI: 10.1055/s-0038-1656362

Original Article

Schattauer GmbH Stuttgart

Activation of Coagulation and Fibrinolysis Following OKT3 Administration to Renal Transplant Recipients: Association with Distinct Mediators

Maarten H M Raasveld

¹The Renal Transplant Unit, Department of Internal Medicine, University of Amsterdam, Amsterdam, The Netherlands

²The Clinical Immunology Laboratory, Department of Internal Medicine, University of Amsterdam, Amsterdam, The Netherlands

,

C Erik Hack

³The Central Laboratory of the Netherlands Red Cross Blood Transfusion Service and the Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam, The Netherlands

,

Ineke J M ten Berge

¹The Renal Transplant Unit, Department of Internal Medicine, University of Amsterdam, Amsterdam, The Netherlands

²The Clinical Immunology Laboratory, Department of Internal Medicine, University of Amsterdam, Amsterdam, The Netherlands

› Author Affiliations

Abstract

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Summary

Treatment with OKT3 induces cytokine release and activates the complement system. Since both phenomena may affect coagulation and fibrinolysis we studied these systems in 8 renal transplant recipients during OKT3 treatment. In 8 of 9 patients a similar pattern was observed: plasma thrombin-antithrombin-III-complex, tissue-type plasminogen-activator and plasmin-α₂-antiplasmin-complex levels were increased as compared to pretreatment levels (p <0.05) at 15 min after the first OKT3 dose and reached peak values at 1 h. No significant changes were observed upon subsequent OKT3 administrations or in a control group of 8 patients. In one patient upon the first OKT3 administration only complement activation, and no cytokine release was observed, whereas plasma thrombin-antithrombin-III-complex, tissue-type plasminogen-activator and plasmin-α₂-antiplasmin-complex levels increased only at 15 min.

In conclusion, we demonstrate a biphasic activation of coagulation and fibrinolysis upon the first OKT3 dose; the initial phase seems to be associated with complement activation, the later phase with cytokine release.

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References

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