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, Dorry Segev, M. Haas, Alexander Tell Hillel, Karen Eileen King, Edward Kraus, L. M. Lees, J. K. Melancon, Z. A. Stewart, Daniel Warren, A. A. Zachary, R. A. Montgomery

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)231-235
Number of pages5
JournalAmerican Journal of Transplantation
Volume9
Issue number1
DOIs
Publication statusPublished - Jan 2009

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Keywords

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

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

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