The use of antibody to complement protein C5 for salvage treatment of severe antibody-mediated rejection

J. E. Locke; C. M. Magro; A. L. Singer; D. L. Segev; M. Haas; A. T. Hillel; K. E. King; E. Kraus; L. M. Lees; J. K. Melancon; Z. A. Stewart; D. S. Warren; A. A. Zachary; R. A. Montgomery

doi:10.1111/j.1600-6143.2008.02451.x

The use of antibody to complement protein C5 for salvage treatment of severe antibody-mediated rejection

J. E. Locke, C. M. Magro, A. L. Singer, D. L. Segev, M. Haas, A. T. Hillel, K. E. King, E. Kraus, L. M. Lees, J. K. Melancon, Z. A. Stewart, D. S. Warren, A. A. Zachary, R. A. Montgomery

School of Medicine

Research output: Contribution to journal › Article › peer-review

228 Scopus citations

Abstract

Desensitized patients are at high risk of developing acute antibody-mediated rejection (AMR). In most cases, the rejection episodes are mild and respond to a short course of plasmapheresis (PP) / low-dose IVIg treatment. However, a subset of patients experience severe AMR associated with sudden onset oliguria. We previously described the utility of emergent splenectomy in rescuing allografts in patients with this type of severe AMR. However, not all patients are good candidates for splenectomy. Here we present a single case in which eculizumab, a complement protein C5 antibody that inhibits the formation of the membrane attack complex (MAC), was used combined with PP/IVIg to salvage a kidney undergoing severe AMR. We show a marked decrease in C5b-C9 (MAC) complex deposition in the kidney after the administration of eculizumab.

Original language	English (US)
Pages (from-to)	231-235
Number of pages	5
Journal	American Journal of Transplantation
Volume	9
Issue number	1
DOIs	https://doi.org/10.1111/j.1600-6143.2008.02451.x
State	Published - Jan 2009

Keywords

Antibody-mediated rejection
Complement inhibitor
Desensitization
Eculizumab
Incompatible transplant
Positive crossmatch

ASJC Scopus subject areas

Immunology and Allergy
Transplantation
Pharmacology (medical)

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10.1111/j.1600-6143.2008.02451.x

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Locke, J. E., Magro, C. M., Singer, A. L., Segev, D. L., Haas, M., Hillel, A. T., King, K. E., Kraus, E., Lees, L. M., Melancon, J. K., Stewart, Z. A., Warren, D. S., Zachary, A. A., & Montgomery, R. A. (2009). The use of antibody to complement protein C5 for salvage treatment of severe antibody-mediated rejection. American Journal of Transplantation, 9(1), 231-235. https://doi.org/10.1111/j.1600-6143.2008.02451.x

Locke, JE, Magro, CM, Singer, AL, Segev, DL, Haas, M, Hillel, AT, King, KE, Kraus, E, Lees, LM, Melancon, JK, Stewart, ZA, Warren, DS , Zachary, AA & Montgomery, RA 2009, 'The use of antibody to complement protein C5 for salvage treatment of severe antibody-mediated rejection', American Journal of Transplantation, vol. 9, no. 1, pp. 231-235. https://doi.org/10.1111/j.1600-6143.2008.02451.x

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abstract = "Desensitized patients are at high risk of developing acute antibody-mediated rejection (AMR). In most cases, the rejection episodes are mild and respond to a short course of plasmapheresis (PP) / low-dose IVIg treatment. However, a subset of patients experience severe AMR associated with sudden onset oliguria. We previously described the utility of emergent splenectomy in rescuing allografts in patients with this type of severe AMR. However, not all patients are good candidates for splenectomy. Here we present a single case in which eculizumab, a complement protein C5 antibody that inhibits the formation of the membrane attack complex (MAC), was used combined with PP/IVIg to salvage a kidney undergoing severe AMR. We show a marked decrease in C5b-C9 (MAC) complex deposition in the kidney after the administration of eculizumab.",

keywords = "Antibody-mediated rejection, Complement inhibitor, Desensitization, Eculizumab, Incompatible transplant, Positive crossmatch",

author = "Locke, {J. E.} and Magro, {C. M.} and Singer, {A. L.} and Segev, {D. L.} and M. Haas and Hillel, {A. T.} and King, {K. E.} and E. Kraus and Lees, {L. M.} and Melancon, {J. K.} and Stewart, {Z. A.} and Warren, {D. S.} and Zachary, {A. A.} and Montgomery, {R. A.}",

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AU - Lees, L. M.

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The use of antibody to complement protein C5 for salvage treatment of severe antibody-mediated rejection

Abstract

Keywords

ASJC Scopus subject areas

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