Recommended Protocol For Okt3 Treatment

Evaluation and treatment before administration Physical examination

Laboratory tests including complete blood count Monitor intake and output; record weight changes Chest radiograph

Hemodialysis or ultrafiltration for volume overload Premedication on day 0 and 1 Methylprednisolone, 250-500 mg IV given 1 h prior to dose Methylprednisolone or hydrocortisone sodium succinate, 250-500 mg IV given 30 min after the dose Diphenhydramine, 50 mg IV 30 min prior to dose daily Acetaminophen, 650 mg PO 30 min prior to dose Discontinue cyclosporine, maintain azathioprine at 25 mg/d Administer OKT3, 5 mg/d IV, days 0-13 Monitor clinical course Check CD3 level on day 3 Increase OKT3 dosage to 10 mg/d if either: Anti-OKT3 antibody is high OKT3 level is low CD3 level is not low

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