Eculizumab for Treatment of Refractory Antibody-Mediated Rejection in Kidney Transplant Patients: A Single-Center Experience. Transplant Proc 2015;47(6):1754-9
Date
08/22/2015Pubmed ID
26293046DOI
10.1016/j.transproceed.2015.06.029Scopus ID
2-s2.0-84939456967 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
Antibody-mediated rejection (AMR) is responsible for up to 20%-30% of acute rejection episodes after kidney transplantation. In several cases, conventional therapies including plasmapheresis, intravenous immunoglobulin, and anti-CD20 therapy can resolve AMR successfully. But in some cases the load of immunoglobulins that can activate complement cascade may submerge the routine desensitization therapy and result in the formation of membrane attack complexes. Eculizumab, a monoclonal antibody against C5, was reported to be an option in cases with severe AMR that are resistant to conventional therapy. Here, we present 8 cases that were resistant to conventional therapy and in which eculizumab was given as a salvage treatment. Given the bad prognosis for renal transplants displaying acute injury progressing rapidly to cortical necrosis on the biopsy, the prompt use of eculizumab could have the advantage of immediate effects by stopping cellular injury. This can provide a therapeutic window to allow conventional treatment modalities to be effective and prevent early graft loss.
Author List
Yelken B, Arpalı E, Görcin S, Kocak B, Karatas C, Demiralp E, Turkmen AAuthor
Emre Arpali MD, PhD Associate Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Antibodies
Antibodies, Monoclonal, Humanized
Female
Graft Rejection
Humans
Kidney Failure, Chronic
Kidney Transplantation
Male
Middle Aged
Young Adult
