title: Eculizumab for Treatment of Refractory Antibody-Mediated Rejection in Kidney Transplant Patients: A Single-Center Experience.
abstract: 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.
authors: Department of Solid Organ Transplantation, Sisli Memorial Hospital, Istanbul, Turkey. Electronic address: bernayelken@yahoo.com.tr.
authors: B
authors: B
authors: Yelken
authors: Department of Solid Organ Transplantation, Sisli Memorial Hospital, Istanbul, Turkey.
authors: E
authors: E
authors: Arpalı
authors: Department of Solid Organ Transplantation, Sisli Memorial Hospital, Istanbul, Turkey.
authors: S
authors: S
authors: Görcin
authors: Department of Solid Organ Transplantation, Sisli Memorial Hospital, Istanbul, Turkey.
authors: B
authors: B
authors: Kocak
authors: Department of Solid Organ Transplantation, Sisli Memorial Hospital, Istanbul, Turkey.
authors: C
authors: C
authors: Karatas
authors: Department of Solid Organ Transplantation, Sisli Memorial Hospital, Istanbul, Turkey.
authors: E
authors: E
authors: Demiralp
authors: Department of Solid Organ Transplantation, Sisli Memorial Hospital, Istanbul, Turkey.
authors: A
authors: A
authors: Turkmen
mesh_terms: D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000276:immunology*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000906:Antibodies; D061067:Antibodies, Monoclonal, Humanized; C481642:eculizumab