Muromonab-(CD3) (Orthoclone OKT3) is a mouse monoclonal antibody that is a purified IgG. It is used for the prevention of acute allograft rejection in kidney and hepatic transplants and as prophylaxis in cardiac transplantation. It is also used to deplete T cells in marrow from donors before bone marrow transplantation.

Muromonab-(CD3) alters the cell-mediated immune response by binding to the CD3 (cluster of differentiation antigen, T3) glycoprotein on T lymphocytes. This binding inhibits lymphocyte activation so that affected T cells cannot recognize foreign antigen and cannot participate in rejecting an organ graft. Within minutes of the first muromonab-(CD3) injection, total circulating T cells are rapidly depleted from the blood. They later reappear devoid of CD3 and antigen recognition complexes.

Adverse side effects include fever, pulmonary edema, vomiting, headache, and anaphylaxis. Neutralizing antibodies may develop over time and necessitate adjusting the dosage upward to compensate for the loss of therapeutic activity.

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