The Use of Antibody to Complement Protein C5 for Salvage Treatment of Severe Antibody-Mediated Rejection

被引：230

作者：

Locke, J. E. ^{[1
]}

Magro, C. M. ^{[4
]}

Singer, A. L. ^{[1
]}

Segev, D. L. ^{[1
]}

Haas, M. ^{[2
]}

Hillel, A. T. ^{[1
]}

King, K. E. ^{[2
]}

Kraus, E. ^{[3
]}

Lees, L. M. ^{[1
]}

Melancon, J. K. ^{[1
]}

Stewart, Z. A. ^{[1
]}

Warren, D. S. ^{[1
]}

Zachary, A. A. ^{[3
]}

Montgomery, R. A. ^{[1
]}

机构：

[1] Johns Hopkins Univ, Johns Hopkins Med Inst, Dept Surg, Baltimore, MD 21218 USA

[2] Johns Hopkins Univ, Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD USA

[3] Johns Hopkins Univ, Johns Hopkins Med Inst, Dept Med, Baltimore, MD USA

[4] Cornell Univ, Weill Med Coll, Dept Pathol, New York, NY 10021 USA

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2009年 / 9卷 / 01期

关键词：

Antibody-mediated rejection; complement inhibitor; desensitization; eculizumab; incompatible transplant; positive crossmatch; PAROXYSMAL-NOCTURNAL HEMOGLOBINURIA; RENAL-TRANSPLANTATION; KIDNEY-TRANSPLANTATION; INHIBITOR ECULIZUMAB; CROSS-MATCH; SPLENECTOMY; ACTIVATION; RITUXIMAB; GLOBULIN; RESCUE;

D O I：

10.1111/j.1600-6143.2008.02451.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

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.

引用

页码：231 / 235

页数：5

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