Pulmonary capillary leak syndrome as a result of OKT-3 therapy.

In 2006 in the United States, 17,093 kidney transplants were carried out, 38% from living donors. More than 5000 patients were added to U.S. renal transplant waiting lists that year, so that more than 70,000 patients were listed at year’s end, and mortality on the waiting list was 7%. It is estimated that 20% to 60% of kidney transplant patients will undergo rejection within the first 6 months. To prevent and treat these episodes of rejection a wide variety of pharmacologic agents have implemented, which include calcineurin inhibitors, corticosteroids, monoclonal antibodies, and polyclonal antibodies. Although these agents have been successful in the management of acute rejection, they also bring forward some unwanted side effects. In this case report, we describe a patient who received muromonab-CD3 (OKT-3) therapy after kidney transplantation for diabetic and hypertensive nephropathy, then subsequently developed severe pulmonary capillary leak syndrome and severe systemic inflammatory response syndrome.